The Dizzy Patient Evaluation
by Dr. Christopher Chang, last modified on
DISCLAIMER: We do NOT consider ourselves "dizzy" experts, but provide the following info as a service to patients. As we are an ENT practice, we will only perform the appropriate testing and evaluation to see if the ears and/or allergies are a cause of a patient's dizziness. Anything more needs to be arranged through your primary care physician or another specialist. Generally speaking, a neurologist is the specialist able to provide the most comprehensive evaluation of dizziness.
The dizziness lasts continuously for weeks to months before improving...
...and is associated with fluctuating hearing loss, ringing of the ears, and/or ear fullness on only one side.
You may have a condition called Meniere's Disease. The dizziness with Meniere's disease is typically described as moderately severe spinning usually preceded by hearing loss, ringing, and ear pressure on only one side without any association with position changes. The dizziness can occur at any time at random and usually lasts anywhere from a few hours to days. Rarely lasts more than one week. Hearing loss that fluctuates occur baseline with or without dizziness. Workup includes audiogram, ENG, VEMP, ECoG, allergy testing, and possibly MRI scan. Treatment is dietary changes first with elimination of salt, caffiene, and alcohol. If this fails, a diuretic is started. In some Meniere's disease patients, aggressive allergy management which may include even allergy shots (if testing positive) are found to be quite beneficial. Food sensitivities has also been found to be an important trigger and elimination of egg, wheat, and dairy has been found to be helpful for some patients. If conservative treatment fails, endolymphatic shunt surgery can be considered. If that fails, vestibular nerve ablation.
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