Vertigo
What You Should Know
There are several types of balance disorders caused by the inner ear, but two
of the most common are Benign Paroxysmal Positional Vertigo and Meniere’s
Disease. We offer vertigo treatment in Orange County, Southern California.
Symptoms
Vertigo literally means the sensation of movement. It is often described
as a sensation of dizziness or spinning, a feeling of falling, lightheadedness
or feeling woozy, visual blurring and disorientation. This may be accompanied
by nausea, vomiting and/or sweating.
Causes
Diagnosis of the cause of vertigo is complicated because there are over 70
different causes of vertigo, and other medical conditions such as ear infections,
blood pressure changes, and vision problems may contribute to the disorder.
Migraines are also a very common cause of vertigo (migraine-associated
vertigo) which may exist even without the typical headaches. Some medications may also
contribute to the problem, we will evaluate your medical situation as part of our vertigo treatment in Orange County. Two of the most common causes of vertigo that we
see are:
Benign Paroxysmal Positional Vertigo (BPPV)
It has estimated that at least 20% of patients who suffer from vertigo have
BPPV. BPPV is defined as an abnormal sensation of motion brought on by certain
positions or movements. It may be accompanied by involuntary eye movements
triggered by inner ear stimulation. Dr. Shohet offers Orange County Vertigo treatment in Southern California.
The inner ear consists of three canals that contain tiny crystals that help
maintain a sense of balance. When particles in the inner ear break off and
accumulate in one of the canals, moving the head in certain directions may
cause the particles to trigger a sense of dizziness.
The symptoms of BPPV include a sensation of spinning and nausea. An individual
may experience BPPV when rolling over to the left or right in bed, when looking
up for an object on a high shelf, looking down or quickly to the side. Episodes
of vertigo generally last less than a minute, but may induce prolonged nausea
or ill feelings. Feel better again with our vertigo treatment in Orange County program.
Two tests may be used to diagnose BPPV. A noninvasive positional procedure
called a Dix-Hallpike test is used to accurately determine if a person has
BPPV. Electronystagmometry (ENG) tests balance function.
Treatment entails a noninvasive positioning procedure. Performing these easy
head maneuvers move the particles out of the canals in the inner ear and can
stop the symptom of dizziness. Medication may also be prescribed to treat
the nausea and dizziness.
For more helpfull tips about Benign Paroxysmal Positional Vertigo (BPPV) and the primary treatment for moving the calcium carbonate particles away from the area that causes nausea and dizziness. When visiting our Newport Beach treatment center, we provide you with comfort and care that stands out among other centers for Orange County vertigo disorder treatment.
Ménière's disease
Ménière's disease is a condition in which excessive fluid
build-up in the inner ear causes episodes of vertigo, fluctuating hearing
loss, tinnitus (a ringing or roaring in the ears), and the sensation of fullness in the
ear. We offer Ménière's disease treatment in Orange County, Southern California.
Diagnosis is based on the findings of a history and examination, and audiometric
and vestibular tests.
Although there is no cure for Ménière's disease, there are
treatment options that can help control the symptoms and lessen the frequency
of attacks of vertigo. Many patients benefit from reducing their intake
of sodium, alcohol and caffeine, and avoiding nicotine. Vitamin supplements
and
diuretics may also help. Vestibular suppressant medications
(such as antihistamines or sedatives) may help calm the inner ear. In
cases where medical management fails to bring relief, surgery may be indicated.
In these instances, Endolymphatic Sac Surgery may be of benefit. This
is a
procedure that drains and opens the endolymphatic sac, the structure that
is responsible for inner ear fluid metabolism. The operation takes approximately
1-2 hours and is performed under general anesthesia at our Orange County office.
Some other cutting edge treatments offered through Shohet Ear Associates
can help alleviate the symptoms of Ménière's Disease. The
Meniett device sends pressure pulses to the middle ear that help reduce
excess fluid
and restore the balance of the inner ear's hydrodynamic system. The treatment
is performed at home several times per day for an indefinite period. For
more information , visit meniett.com.
In severe cases of episodic vertigo, Transtympanic Gentamicin
treatment may be used to deaden the balance portion of the inner ear. Injections
of a drug called gentamicin are given through the ear drum using a small
needle. This procedure can be used to treat one side, without affecting
the other.
The procedure carried at our Orange County treatment center is not usually painful because an anesthetic is used to numb
the ear drum. Between one and three treatments are usually necessary.
Diagnosis
The first step is a thorough evaluation as part of our vertigo treatment in Orange County CA. Diagnostic tests that may be conducted
include Electronystagmography (ENG) and Vestibular Autorotational Test (VAT)
to evaluate balance function. Electrocochleography (ECOG) and Auditory brainstem
response tests (ABR) assess the cochlea and acoustic nerve. Shohet Ear Associates
offers the full range of computer-assisted technology in our office to help
determine the cause of these disabling conditions.
Treatment
There are various options for treating the causes of vertigo. Depending on
the diagnosis, treatment may involve sophisticated, multidisciplinary methods
or simpler approaches to curing the root cause of the balance disorder.
One option includes treatment for conditions that may be contributing to
the balance problem, such as ear infection, BPPV or Ménière's
disease. Another possible Orange County treatment option includes balance retraining exercises
(vestibular rehabilitation) that help patients to compensate for their balance
disorder. The exercises include movements of the head and body developed especially
for the patient. Vestibular retraining programs are conducted by professionals
with knowledge and understanding of the vestibular system and its relationship
with other systems in the body.
| Small amount of gentamicin antibiotic injected behind the ear drum
in the office. |
- Office procedure
- Local anesthetic
- 30 min procedure
- Brief
recovery period
- Can repeat injections
|
- Some discomfort with procedure
- May require repeat injections
- Must
keep ear dry for one week
- Occasional disequilibrium - may require
balance physical therapy
|
- Ear drum perforation
- Infection
- Hearing
loss (5-25%)
- Dysequilibrium
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| A small vent tube is placed in the ear drum. Then, an ear plug type
device is worn that delivers low pressure pulses to the inner ear on
a daily
basis. |
- Office procedure
- Local anesthetic
- Portable device
- No "down
time"
- Option for bilateral disease
|
- Requires daily use of device
- Three treatments of 5 min
each, daily
- May need to use indefinitely
- Must
avoid water in ear with tube
|
- Ear drum perforation
- Infection
- Tube may dislodge
- Hearing
loss (1-2%)
|
- 67% control vertigo
- 27% improve hearing
|
| The endolymhatic sac within the inner ear is decompressed surgically.
Then the excess fluid is free to drain. |
- Good control of vertigo
- May improve hearing
- Low
morbidity
- Single procedure
|
- Outpatient surgery
- General anesthesia
- Return to
work within one week
|
- Surgical discomfort
- Infection
- Hearing loss (1-2%)
- Ear
fullness
- Facial paralysis (<1%)
- Spinal fluid leak (<1%)
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- 81% control vertigo
- 20% improve hearing
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| Note: |
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| With any of these options, although they may be successful
initially, they may not be permanent. Secondly, undergoing one option now
does not eliminate the opportunity to try an alternative therapy in
the future. |
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