Dizziness afflicts people of all ages. It is the second most common complaint following lower back pain, in people over 50. It is described as unsteadiness, spinning, whirling, light-headedness, swimming in the head, and staggering, etc.

Cause of Dizziness

Dizziness can be caused by either inner ear problems or other general conditions:

Inner Ear Dizziness

Meniere’s Disease with episodic dizziness, fullness, hearing loss in one or both ears, ear noise, nausea, etc.

Viral Infection of the inner ear nerve with severe dizziness lasting for a few days without any hearing problem.

Benign Paroxysmal Vertigo with the dizziness occurring only when the head is in a specific position.

Acute Occlusion of the feeding blood vessel to the inner ear with or without hearing loss.

Other Disorders, such as head trauma, leak of the inner ear fluids, ototoxic drugs, and other rare conditions.


Central General Dizziness

Circulatory Problems, such as a stroke, occlusion or spasm of some arteries in the brain.

High or low blood pressure.

Abnormal Heart Rate: slow, fast, or irregular.

Medications, such as sleeping pills, antihistamines, blood pressure medications, ototoxic drugs, or nerve pills.

General Medical Condition, such as anemia, kidney problems, liver or visual problems, etc.

Neurological Problems, such as a brain tumor, stroke, spinal cord tumors, cerebral or cerebellar atrophy.


Examination and Testing

In order to diagnose your problem, one or more of the following tests will be performed:

Hearing Test (Audiogram)
Since the hearing and the balance components of the inner ear are closely related, testing the hearing is very valuable.

Computerized Inner Ear Test (Electronystagmogram / ENG)
The computer monitors the eye movements that are elicited by the inner ear due to direct connection between them and centers that control the eye movement. The head electrodes will be pasted around the eyes and the head will be placed in various positions. The ears will be irrigated with slightly warm and cool water.

Computerized Rotary Chair
Your eye movements will be monitored as you turn around at different speeds in a darkened room. This test is helpful when the ENG results are inconclusive, checking children, or following head trauma.

Auditory Brain Stem Evoked Response Potential Test
This studies the transmission of the sound from the inner ear to the brain. It is helpful in ruling out tumors pressing on the nerve of hearing.

Allergy Testing
Either through computerized evaluation of a blood sample or skin testing.

X-rays, CT scan or MRI can be helpful.

Other tests such as blood tests, medical evaluation and other general or specialized studies may be needed to help determine the cause of imbalance.


After the diagnosis is established, one or more of the following methods of treatment will be used. However, treatment can be lengthy and requires your patience and cooperation.

Inner Ear Suppressants
These drugs control the abnormal emission of stimuli from the inner ear and help keep you comfortable while the inner ear has a chance to recover.

Fluid Pills (diuretics)
Diuretics are helpful in Meniere’s Disease.

These help improve the circulation in the inner ear.

Low salt diet is very helpful in Meniers’s Disease. Eliminating caffeine reduces stimulation of the inner ears. Balanced diet and good eating habits control fluctuations in blood sugar levels.

Physical Therapy and special exercises can also be helpful.

Reserved only for those cases which do not improve with other measures. There are several surgical procedures, depending on the type and nature of the disease.

Treatment for Central Dizziness is directed toward the cause, such as high blood pressure, low blood pressure, low thyroid, neurological diseases, etc.

For additional information or to make an appointment, please contact River Cities Ear, Nose & Throat Specialists, P.L.L.C. at (304) 522-8800 or (800) 955-3277.


B. Joseph Touma, M.D.
Touma Ear and Balance Center
1616 13th Avenue, Suite 100
Huntington, WV 25701
304.522.8800 or 800.955.3277

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