Dizziness – A common complaint with many causes

When complaining of dizziness patients often describe a wide variety of symptoms ranging from mild to severe. Common complaints include:
* Light-headedness
* A feeling of movement
* Feeling like they are on a boat
* Feeling that they are spinning
* Feeling that the world is spinning
* Seeing black spots
* Feeling like they are going to pass out
*Passing out (syncope)
*Blurred or double vision
*Problems focusing
*Just feeling off balance

It is very important for a practitioner to understand that these symptoms are not one in the same and that evaluating and treating them as such, leaves the patient frustrated and still symptomatic. It is common, with any of these complaints, for patients to be labeled as having vertigo and being sent home with exercises or rest.

Complaints of dizziness can be a result of either central neurological dysfunction or peripheral neurological dysfunction. Peripheral dysfunction is commonly seen in cases of BPPV where the issue resides in the inner ear and, if treated properly, can be quickly resolved.

When the issues are more central in the brain itself is when people notice more chronic symptoms, they may come and go, with episodes increasing in severity over months or years. It is important to know that chronic repetitive episodes of BPPV may also cause a central consequence and you may continue to suffer from episodes off and on, despite having had an Epley Maneuver performed.

Unresolved central issues can leave patients with on going symptoms. We see this issue commonly in our patients as they have already sought treatment with some or no improvement because the issue was not being addressed from a central perspective. The vestibular system is just that, a system. We cannot isolate these symptoms solely to the vestibular apparatus itself (the inner ear) because that part of the system communicates with the cerebellum and the brainstem directly. If we do not look at these areas as potential causes of dysfunction many people’s symptoms do not get addressed properly.

As Functional Neurologists, we are extensively trained to recognize and differentiate these conditions to treat the root cause or your symptoms. This is done through a proper history, clinical examination and diagnostic testing to evaluate brain function and target the specific areas or pathways in the brain that are leaving you with debilitating symptoms of dizziness and worse.

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