The sense of balance comes from input from the eyes, inner ear and sensors on muscles and joints. Disruption of one or more of these inputs results in a sense of imbalance.

Ear infections, inner ear disease and inherited diseases can cause dizziness. It is important to check the hearing in anyone with a balance disorder as the same disease process may affect it.

Benign paroxysmal positional vertigo. (BPPV)

This condition causes several bouts of dizziness during the day with each episode lasting a few seconds. The cause is still debated in the scientific literature but we do know that small crystals stimulating the inner ear balance organ cause the dizzy episodes. The treatment (Epley Manoeuvre) involves a series of head movements designed to relocate the crystals to another part of the inner ear where they do not stimulate the balance organ

Acute Labyrinthitis

An acute bacterial or viral infection of the inner ear can cause severe dizziness with may patients confined to bed for a few days with severe vomiting. Treatment is essentially supportive during the acute phase, this includes rehydration, and short term vestibular sedatives. Some people may fully recover but some are left with underlying damage to the balance organ and persistent dizziness.

Meniere’s Disease

This is a specific disease that causes bouts of dizziness lasting several hours, tinnitus (noises in the ear) and fluctuating hearing loss. The disease is caused by fluctuating fluid in the inner ear (hydrops).

It initially affects one ear then eventually both. Patients have over time a progressive hearing loss particularly in the low frequencies. Medical treatments include a low salt diet and the use of diuretics to help with the increased middle ear fluid, medication for the acute attacks, hearing aids. Surgery may be used in severe cases and include gentamycin injections through the eardrum which can help with the dizziness but may cause a hearing loss. Endolyphatic sac decompression may help release the pressure in the inner ear and provide overall symptomatic relief.