The inner ear has a mechanism called the vestibular system that controls balance. Inside the system are semicircular canals with ducts, tiny hairs cells (stereocilia) and a thick gel structure called the cupula. When you turn your head, stand up or sit down, the gel moves against the stereocilia and receptors tell the brain that your body has changed orientation.
When the inner ear becomes infected, grows a tumor or encounters trauma, these structures may malfunction. When this happens, you can experience vertigo and other balance related symptoms. For some people, balance and inner ear disorders are hereditary and lifelong.
Symptoms of vertigo go beyond simply dizziness; they include feeling disoriented, nauseous and weak as well as producing erratic eye movements. Vertigo is sometimes associated with an illusion of movement – feeling like you are swaying or falling even if you are perfectly still. Since vertigo is connected with inner ear problems, someone experiencing vertigo may also have hearing loss and ringing or discomfort in the ears.
The most common tests for inner ear-related vertigo or balance issues include electronystagmogram (ENG) or videonystagmogram (VNG) procedures wherein warm or cool air is softly blown into the ear canal and then eye movements are measured. The purpose of this is to test the strength of the inner ear as well as eye movement coordination.
Treatment for vertigo takes many forms depending on the cause. Your physician will try to target the underlying condition in order to reduce or eliminate the symptoms. Options include medications (antihistamines, sedatives, antibiotics, steroids), physical or occupational therapy, surgery, repositioning exercises, vestibular retraining programs and lifestyle modifications such as dietary changes and elimination of alcohol and nicotine.
The most common form of vertigo is benign positional vertigo (BPV). BPV is a sensation similar to spinning and can be triggered by tilting your head up or down, turning over, lying down or getting up. BPV is caused by disturbances of the vestibular system in the inner ear. BPV occurs when crystals of calcium carbonate clog the semicircular canals, because the vestibular system then sends mixed messages to the brain about the body’s position. Although the most common symptom of BPV is dizziness or a “spinning” sensation, other symptoms include vomiting, blurred vision, nausea, lightheadedness and loss of balance. BPV is diagnosed by a test called the Dix-Hallpike maneuver wherein a doctor holds your head in a certain position while you lie down quickly. The doctor then monitors eye movements and asks you to describe your symptoms.