WVU Balance Center

Help for Dizziness

vertigo2Dizziness, that awful feeling of spinning or falling, can be associated with a number of different health issues. Feeling dizzy can also be dangerous, so finding the problem and fixing it is important.

The new WVU Balance Center can help if you have repeated episodes of dizziness. The Center is a coordinated effort by a group of our physicians and therapists, including:

  • ear, nose, and throat doctors
  • audiologists
  • physical therapists
  • neurologists
  • gerontologists

What causes dizziness?

The cause of dizziness may not always be simple to detect. Dizziness can be inner-ear related. Meniere’s disease, viral or bacterial infections, and head injuries can affect the inner ear, throwing off the delicate system that controls balance.

Older people may have trouble with dizziness and balance, conditions that are related to age and muscle weakness. Sometimes stroke victims have lingering neurological issues. Even some medications can impair balance.

Our doctors will determine if your dizziness is ENT-related. If it’s not, the ENT doctor will recommend another physician associated with the Balance Center who can help. Most problems can be resolved through medication, surgery, or therapy.

If you have more than one healthcare provider to see regarding your dizziness, the Balance Center schedules the appointments on the same day.

Learn More

Meniere’s Disease
Dizziness Testing
Dizziness Rehabilitation

Meniere’s disease is an inner ear problem that causes periods of vertigo (spinning) that can last from 20 minutes to several hours and often results in nausea. The vertigo is usually accompanied by hearing loss, tinnitus (ringing in the ears), and a pressure sensation in the ear or on the side of the head. Meniere’s disease is rare in children but can occur in adults of any age.

One of the characteristics of Meniere’s disease is its unpredictable nature; the spells can occur from once a day to once a year. Over the course of months to years, the person’s hearing tends to fluctuate less with the spells and often is reduced between spells.

Meniere’s disease is thought to result from an excess of fluid in parts of the inner ear. The main treatment consists of a diuretic (a pill that helps the body get rid of excess fluid) and a low-salt diet. Additional treatments may include medication to suppress dizziness, such as meclizine (Antivert©) or diazepam (Valium©).

The majority of people with Meniere’s disease get relief with medical treatment. Those who fail medical treatment are offered surgical treatment, which is often successful.

WVU Medicine Health Report: Meniere’s Disease

ENG/VNG (Electronystagmography/Videoonystagmograph)

ENG testing is used to find the cause of a person’s dizziness. Electrodes are taped around the eyes to detect jerky eye movements. We use a newer technology, called videonystagmography (VNG), which employs infrared video signals to detect eye movements. Problems with the ear or central vestibular (brain) systems can be detected. The test takes a little over an hour and must be performed without the influence of medication that suppresses dizziness.

Assessing Balance

In addition to VNG, balance can be evaluated by standing up and using different feedback conditions.

For example, you might be asked to stand up and stay still with your eyes open at one time and with eyes closed at another time. Under another condition, you may be asked to stand on an unsteady surface (a foam pad or slightly tilted surface), again with eyes open versus eyes closed.

WVU Health Report: Dizziness

We treat certain types of dizziness with a therapy called vestibular rehabilitation. If your dizziness stems from changes in body posture or head position, you may be a candidate for this treatment.

As part of the evaluation, you will be given hearing and balance tests. If the vestibular exercise program is appropriate for you, our therapist will teach you how to do the exercises so you can perform them at home.

The exercises help readjust your balance system and are tailored to fit your diagnosis and physical condition. Most of the exercises will temporarily make you feel more dizzy in order to condition the brain to overcome the dizziness. The program usually lasts for at least 6 weeks.

If you are diagnosed with benign paroxysmal positional vertigo (BPPV), you may respond to a maneuver called particle repositioning, which will help you overcome this form of dizziness. If you have uncomplicated BPPV, you can be treated in the doctor’s office.

If you have motion-induced dizziness, you may benefit from vestibular rehabilitation. People who experience unpredictable episodes of dizziness, such as those with Meniere’s disease, are not candidates for vestibular exercises.

Adam Cassis, MD

Director, Otology and Skull Base Surgery; Assistant Professor
View Profile304-598-4000

Ralph Utzman, PT, MPH, PhD

Professor, Director of Clinical Education
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