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ENT Surgical Associates Michigan


Dizziness & Balance

Diagnosis and Treatment of Balance Disorders

Patients with balance disorders may be tested with electronystagmography (ENG), auditory brainstem evoked response (ABR), audiometry, and vestibular autorotation testing (VAT) available at the office of E.N.T. Surgical Associates.

Dizziness (Vertigo)

Dizziness and vertigo are often caused by disorders of the inner ear. In addition to hearing, the ear's "vestibular system" functions to help control our balance.  Therefore, an evaluation by an ENT physician to rule-out an inner ear problem is recommended for many patients with dizziness or vertigo.


Dizziness can be described in many ways, such as feeling lightheaded, unsteady, giddy, or feeling a floating sensation. Vertigo is a specific type of dizziness experienced as an illusion of movement of one’s self or the environment.

Some experience dizziness in the form of motion sickness, a nauseating feeling brought on by the motion of riding in an airplane, a roller coaster, or a boat. Dizziness, vertigo, and motion sickness all relate to the sense of balance and equilibrium. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:

  • The inner ear, which monitors the directions of motion, such as turning, rolling, forward-backward, side-to-side, and up-and-down motions.

  • The eyes, which monitor where the body is in space (i.e., upside-down, right-side up, etc.) and also directions of motion.

  • The pressure receptors in the joints of the lower extremities and the spine, which tell what part of the body is down and touching the ground.

  • The muscle and joint sensory receptors tell what parts of the body are moving.

  • The brain and spinal cord, which processes all the information from the four other systems to maintain balance and equilibrium.

The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.

Vertigo can be caused by many things, but most cases are due to one of the three conditions listed below:

  • Infection, such as the ones that cause the common cold, can cause temporary vertigo via an ear infection. This inner ear infection is generally viral and usually goes away within a few weeks, but medications are available if it’s severe.
  • Benign paroxysmal positional vertigo or BPPV, is caused by movement of a tiny calcium particle/crystal (otolith), the size of a grain of sand, from the part of the ear that senses gravity to the part that senses rotation motion. The person feels as if they are turning or spinning when they aren’t. A therapy done in the doctor's office can reposition the otolith back to where it belongs and fix the problem. This therapy is called an Epley maneuver, and cures approximately 80% vertigo due to BPPV.
  • Meniere's disease is a disorder characterized by long-lasting, recurring episodes of vertigo that can range from mild to severe. Other symptoms of Meniere's disease include ringing in the ear (tinnitus), fluctuating hearing loss, and pressure or fullness in the ear.

Most cases of dizziness and motion sickness are mild and self-limited. But severe cases and those that become progressively worse deserve the attention of a doctor with specialized skills in treating diseases of the ear, nose, throat, balance, and equilibrium systems.