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What causes my vertigo and how can it be successfully managed?

You may have had the unfortunate experience of having vertigo. This is the term we use to describe a dizziness sensation with a spinning or rotational feeling. Either you feel like you are spinning or that the environment is spinning around you.

A typical history may be an initial severe episode of vertigo, severe nausea and possible vomiting. Frequently this is when the patient wakes up in the morning. That day the symptoms can be so severe that it may have resulted in an ER visit. Typically the ER rules out things like stroke with a CT scan and will provide symptomatic relief. You leave with a diagnosis of vertigo and instructions to see an ENT.  This type of episode is actually called labyrinthitis.

 

What Causes Labyrinthitis?

This disorder is an inflammation of the inner ear balance organ on one side. Since the sense of balance is controlled by the balance of input from each inner ear organ the reduction in function on one side creates the vertigo complaint. The sensory input from the eyes, the other normally functioning inner ear, and the body’s proprioceptors in the spine are in disagreement with the input from the inflamed and dysfunctional inner ear.

The body sends warning signals that the system is out of balance including nausea, sweating, anxiety, and elevated heart rate. The treatments in the ER are essentially symptomatic treatments for these warnings. They are not a treatment for the labyrinthitis​.

We can treat an episode of labyrinthitis in two ways.

  1. A special set of diagnostic tests including a hearing test and balance test can identify which ear has been injured. A steroid injection to that ear – (trans-tympanic dexamethasone treatment) can be done as an office procedure to reverse the actual inflammation of the inner ear. This is done under topical anesthesia and is painless. It is usually done with an oral steroid as well.
  2. The cause of the labyrinthitis is usually from nasal and sinus inflammation. A CT scan of the nose and sinus is done to evaluate and resolve any sinus issues to help resolve this episode and reduce the risk of recurrence. If this step is not done, the episodes may continue to recur. This treatment may require medical therapy for sinus infection, allergy management, and in some instances where sinus infection is persistent after medical therapy a balloon sinuplasty can be of great benefit.

Schedule A Consultation

If you have suffered from an episode or more of vertigo and did not get a comprehensive evaluation and treatment plan, this should be done. Contact us today at 512.601.0303 to schedule an appointment!

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