Dr. Hazenfield -- Ear, Nose, and Throat Doctor in Hawaii

Dizziness

Hugh N. Hazenfield, M.D., F.A.C.S.

• "Dizziness" is a term for several different symptoms:

  • Sensation of an impending faint

  • Sensation of an impending fall

  • Light-headedness (drunk sensation)

  • Spinning vertigo

• Dizziness has many possible causes and is not always due to ear problems:

  • Metabolic disease, including diabetes and thyroid disorders

  • Orthostatic hypotension (the blood pressure drops on sitting up or upon standing)

  • Arthritis of the spine in the neck

  • Temporomandibular joint problems ("TMJ")

  • Anemia

  • Vascular disease (decreased blood flow to the brain due to arterial occlusion)

  • Heart disease, especially arrhythmias

  • Strokes

  • Brain tumors

  • Trauma to the skull or temporal (ear) bone

  • Inner ear disorders

  • Viral infections (theoretically involving the inner ear, nerve to the ear, or arteries to the ear)

  • Meniere's Disease (or endolymphatic hydrops)

  • Middle ear infections

  • Middle ear effusions (fluid behind the ear drum, especially if only on one side)

  • Acoustic neurinoma (benign tumor on the nerve to the ear)

• Evaluation of dizziness may involve the following specialists:

  • Neurologist (evaluates brain and nerve function)

  • Otolaryngologist (evaluates possible ear causes)

  • Cardiologist (evaluates heart problems which may cause dizziness)

  • Vascular surgeon (evaluates decreased blood flow or other possible vascular causes)

  • Endocrinologist (evaluates for diabetes or other disorders)

  • Audiologist (upon referral from a physician, evaluates hearing by audiogram and equilibrium disorders by a test called an electronystagmogram)

  • Radiologist (upon referral from another physician, performs and reads computerized tomography scan and/or MRI)

• Treatment of Dizziness:

  • Treatment depends upon the cause

  • Keep yourself very well-hydrated with water

  • Non-specific anti-dizziness or anti-nausea medicines

  • Sedatives

  • Treatment of diabetes or metabolic disease

  • Occasionally antibiotics and/or systemic steroids

  • Occasionally surgery

  • Occasionally radiation therapy, including the gamma knife

  • Dizziness is often self-limited and resolves in 6 - 12 weeks

• When to seek medical attention:

  • If dizziness in any form lasts for more than a few seconds or recurs

  • If dizziness is accompanied by any of the following symptoms:

    • Ear drainage

    • Ear pain

    • Headaches

    • Nausea & vomiting

    • Fullness in the ear

    • Hearing loss, especially in one ear

    • Tinnitus, or ringing in the ear

    • Actual falling

  • Call your primary care physician for an initial evaluation.  He or she may treat you initially or refer you to a specialist.