Understanding Dizziness, Vertigo & Balance Disorders


Florida Gulf Coast Ear, Nose & Throat

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Posted on

Aug 08, 2023


Florida - Southwest

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What Is a Balance Disorder? Your sense of balance is critically important to help prevent falls and injury. A balance disorder affects your body’s ability to hold an upright, safe position and is often experienced as dizziness and vertigo. Dizziness is a feeling of being unsteady or having a distorted sense of your body in the space in the space around it. Vertigo involves a sense a movement, as if you or the environment around you is spinning. Dizziness and vertigo can be accompanied by lightheadedness, blurred vision, confusion, disorientation, nausea, and vomiting. Dizziness and vertigo are symptoms of numerous conditions, including anxiety, dehydration, circulation issues, nervous system and brain conditions, medication side effects, and inner ear disorders. An ENT can help you determine if your dizziness or vertigo is caused by an inner ear disorder.

Balance and the Inner Ear Your sense of balance is guided by signals from your eyes, ears, and sensory receptors to your brain. The part of your ears involved in balance is called the vestibular system, a structure of bone and soft tissue located in your inner ear. Within this structure are loop shaped canals that contain fluid hairlike sensors. When you move your head, the fluid in the vestibular system causes the hairlike sensors to bend, sending a signal to your brain that your head has changed position. With this information, your brain can send signals to other parts of the body, such as your eyes and muscles, to move your body’s position and visual focus to help maintain your sense of balance. When any part of the vestibular system is injured or malfunctioning, proper signals to your brain can be disrupted, causing you to feel imbalanced. When the vestibular system is the cause of your sense of imbalance, it is called a vestibular disorder. 

Common Vestibular Disorders

Autoimmune Inner Ear Disease (AIED) Autoimmune Inner Ear Disease is caused by a malfunctioning immune system that attacks healthy ear tissue. It affects both ears and causes hearing loss and balance issues. Once symptoms are present, they typically progress quickly. AIED is rare, affecting 15 out of 100,000 people, and is most common in middle-aged women. It commonly occurs with other autoimmune diseases such as rheumatoid arthritis, lupus, scleroderma, and ulcerative colitis. Acoustic Neuroma Acoustic neuroma is a benign (non-cancerous) tumor that grows on the nerves in the inner ear that are responsible for hearing and balance. The pressure on the nerve from the tumor may cause hearing loss and imbalance. Benign Paroxysmal Positional Vertigo (BPPV) Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. The structures in your ear that monitor your head's movements crystals that make you sensitive to gravity. These crystals can become dislodged for several reasons, such as serious trauma to the head or even minor trauma such as a violent sneeze or bumping your head into something. When the crystals become dislodged, they can move into the canals of the vestibular system and create a fall signal of head movement, causing dizziness. Benign paroxysmal positional vertigo can occur at any age but is most common in people over the age of 50.Mal de Debarquement Syndrome (MdDS)

Mal de Debarquement Syndrome (MdDS) Mal de Debarquement Syndrome is a rare condition that causes a severe and often debilitating feeling of swaying or bobbing, much like motion sickness but without motion. It often follows boat or ship travel but can persist for months or longer. While it is a neurological condition rather than a vestibular condition as it does not involve the inner ear, patients often see ENT physicians for a diagnosis. Ménière’s Disease Ménière’s disease causes severe vertigo, ringing in the ears, hearing loss, and a feeling of fullness or congestion in the ear. In Ménière’s disease, a buildup of fluid in the inner ear interferes with the vestibular nerve’s ability to send signals that regulate balance to the brain. Ménière’s disease usually affects only one ear but over time can progress to affect both ears. Labyrinthitis Labyrinthitis is a disorder of the inner ear that occurs when one of the vestibular nerves becomes inflamed. It is commonly caused by a viral infection, such as an upper respiratory infection or the flu, or less commonly by a bacterial infection such as strep throat or pneumonia. Otosclerosis Otosclerosis is a rare condition characterized by an abnormal growth of bone of the middle ear. It commonly affects hearing loss, and less commonly can affect balance if the growth extends into the inner ear. Ototoxicity Ototoxicity is caused by exposure to certain drugs or chemicals that damage nerves in the inner ear that are responsible for hearing and balance. There are more than 200 prescription and over-the-counter medications and chemicals that are known to cause ototoxicity. Discuss with your doctor the potential for hearing or balance damage of any medication you are taking. Vestibular Migraine Vestibular migraine is one of the most common causes of spontaneous vertigo, loss of balance and sensitivity to motion. Unlike other migraines, vestibular migraine may or may not feature headache, although most people diagnosed with vestibular migraine have a history of migraine headaches. Although vestibular migraine is a neurological condition, it can mimic vestibular conditions such as Ménière’s disease and patients should consult an ENT physician to rule out any inner ear disorders. Vestibular Neuritis Vestibular neuritis, or vestibular neuronitis, is characterized by inflammation of the vestibular nerve in the inner ear. It causes a sudden case of severe vertigo, dizziness, balance problems, nausea and vomiting that can last for minutes or prolonged over several days. Vestibular neuritis is typically caused by a virus either in the ear or elsewhere in the body.

Diagnosing Vestibular Disorders

The otolaryngologists at Florida Gulf Coast ENT and the audiologists at Florida Gulf Coast Hearing Center are trained to performed diagnostic tests for vestibular function. Tests they may perform include: Your otolaryngologist may consult with other physicians such as neurologists to assess neurological conditions, and cardiologists to assess circulatory conditions. Hearing tests – To evaluate hearing functionality Electrocochleography (ECoG) – Measures inner ear fluid pressure Electronystagmography (ENG) or Videonystagmography (VNG) — Measures eye movement and the muscles that control them Head movement testing – Evaluates the effect of tilting your head Rotational chair testing – Measures eye movements while you sit in a computerized chair that moves Posturography – Measures your ability to maintain proper posture under different test conditions Subjective visual vertical test (SVV) – Measures how your inner ear senses gravity Vestibular evoked myogenic potential (VEMP) – Evaluates the functionality of the inner ear and vestibular nerve Blood tests - To check for infections Your otolaryngologist may consult with other physicians such as neurologists to assess neurological conditions, and cardiologists to assess circulatory conditions.

Treating Vestibular Disorders Your treatment plan will depend on which type of vestibular disorder you have. Options may include: Medications to treat an infection Medications to prevent vertigo and nausea Treatment of underlying conditions Surgery to repair inner ear function Dietary changes Activity changes Physical or occupational therapy Be Safe When Feeling Dizzy  Dizziness and vertigo increase the risk of falling and injuries. To minimize this potential, consider taking these safety precautions: Minimize driving Minimize going up and down the stairs Walk with a cane or walker Install “grab bars” in the bathroom Wear low-heeled shoes .

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Sleep Deprivation And Its Effects On Your Brain

We all know that getting a good nights rest is important. It helps keep our immune system healthy and allows us to function properly throughout the day. However, weve all experienced those days after either a late night or a restless night in bed where we dont feel as sharp, and our brain is a little foggy.Sometimes that sleep debt, or the total amount of sleep lost due to poor sleep, can be harder to make up than you think. And in addition, that sleep deprivation might be having serious effects on the brain and could be doing unrepairable damage. Just as the rest of our body needs sleep to stay healthy, so does our brain.What Is Sleep Deprivation?Simply put, sleep deprivation is when you do not get enough sleep. The number of hours of sleep a person needs varies from person to person. However, most adults require seven to nine hours of good-quality sleep every night.Sleep deprivation occurs when you dont get that many hours, whether due to an underlying health condition or another extenuating circumstance, such as work or stress. There are two main types of sleep deprivation: acute sleep deprivation and chronic sleep deprivation.Acute sleep deprivation is when there is a short-term interruption in your sleep. For example, if you stay up late binge-watching your favorite television show, that is considered acute sleep deprivation. Chronic sleep deprivation occurs when you suffer from inadequate sleep for a prolonged period weeks, months, or even years.Symptoms Of Sleep DeprivationThe most significant telltale sign that youre sleep deprived is the overwhelming feeling of exhaustion and fatigue. If youre struggling to stay awake or are having difficulty concentrating or thinking clearly, theres a good chance youre not getting enough sleep.Other symptoms include:Diminished sex driveIrritabilityFatigueMemory issuesDepressionLack of motivationPoor judgmentIf youre experiencing any of these signs of sleep deprivation, you should have an honest conversation with your provider. Your symptoms could just be related to lack of sleep, or they could be signaling youre suffering from an underlying health condition.Its important that you address your sleep deprivation to prevent long-term damage. Because regardless if your sleep deprivation is acute or chronic, its affecting your brain and quality of life.How Sleep Deprivation Affects Your BrainSleep is vital for the health of your brain. Without good sleep, you cant focus or learn properly, as poor sleep affects a part of the brain called the hippocampus, which is key for making new memories. Lack of sleep also drops your ability to learn new things by 40 percent.Contrary to what you may believe, your brain is still very much active when youre asleep. Its during your slumber when brain waves are produced that help transfer memories from the hippocampus to the prefrontal cortex-where long-term memories are stored.In addition to storing and making memories, research has found that sleep, particularly deep sleep when youre not dreaming, is integral in reducing your risk of Alzheimers. Poor sleep is a hallmark of Alzheimers disease in that during your deep sleep stage (non-REM), your brain is busy cleansing and washing away toxins and waste that have formed throughout the day. And one of those wastes is beta-amyloid a precursor protein that is known to contribute to the onset of Alzheimers.So, with that theory, if you dont get enough sleep, your brain will accumulate more and more beta-amyloid until a plaque is formed. In a brain with Alzheimers, abnormal levels of plaque begin to collect between neurons and disrupt cell function, thus leading to memory loss and dementia.Give Your Brain The Sleep It NeedsTheres no way around it. Sleep is essential to brain health. And its important to note that the sleep debt you build up now may not be able to be paid back later. Sleep deprivation can ultimately come with some costly effects on your brain. So you have to do all you can now to protect your brain and health for the future.You can accomplish this by establishing a good sleep schedule and nightly routine that promotes a healthy sleeping environment. For example, dont sleep with lights on or lights in the dark, such as a nightlight or a clock light, that will distract you and keep you from sleeping. Instead, create an environment conducive to a good nights rest. Because quality is just as important as quantity when it comes to sleep!

Recognizing The Warning Signs Of Neuropathy

Neuropathy is a condition that affects the peripheral nervous system. It can have a profound impact on your quality of life. Characterized by nerve damage, neuropathy can show up in various ways. Its crucial that you take note of symptoms and seek timely medical attention so the condition can be managed effectively. Here are some of the most common warning signs of neuropathy and how you should address them. Understanding NeuropathyNeuropathy, often referred to as peripheral neuropathy, is a term used to describe a group of disorders that result from damage to the peripheral nerves. These nerves are responsible for transmitting signals between the central nervous system (the brain and spinal cord) and the rest of the body, including the limbs, skin, and internal organs. When these nerves are damaged, they send abnormal signals to the brain, leading to a wide range of symptoms. The leading cause of neuropathy is diabetes. Poorly managed diabetes (blood sugar) accounts for roughly 60 percent of the total number of people with neuropathy. Most of the patients develop symptoms after 10 years of being diagnosed with diabetes mellitus, said VIPcare primary care provider Dr. Richard Santiago. All depends on how well the diabetes is controlled.Common Warning Signs Of NeuropathyNeuropathy can be displayed in a variety of ways and symptoms. This often leads to neuropathy being mistaken for some other condition, such as fibromyalgia. However, there are specific warning signs of neuropathy you should take notice of if present. Almost all the symptoms are on lower extremities, said Dr. Santiago. The symptoms that Im looking at are pain, burning sensation, tingling, numbness, and unbalance. Numbness and Tingling: One of the earliest and most common signs of neuropathy is a sensation of numbness or tingling, often described as a pins and needles feeling. This can occur in the hands, feet, arms, or legs.Burning Sensation: Individuals with neuropathy may experience a persistent burning or electric shock-like sensation in the affected areas.Loss of Sensation: As neuropathy progresses, some individuals may notice a decreased ability to feel temperature changes, pain, or touch in the affected areas.Muscle Weakness: Neuropathy can lead to muscle weakness or a feeling of heaviness in the limbs, making it difficult to perform everyday tasks.Balance Issues: Nerve damage can affect proprioception (the sense of body position), leading to balance problems and an increased risk of falls.Pain: Neuropathic pain can range from mild discomfort to severe shooting pain. It may be constant or intermittent and can significantly impact a persons daily life.Difficulty Walking: As neuropathy progresses, some individuals may experience difficulty walking or have an unsteady gait.Changes in Reflexes: Neuropathy can affect reflexes, leading to abnormally brisk or diminished responses.Sensitivity to Touch: Some individuals may become hypersensitive to touch, experiencing pain or discomfort even from gentle contact.Digestive Issues: Neuropathy can affect the nerves controlling the digestive system, leading to symptoms such as bloating, constipation, diarrhea, or difficulty swallowing.When To Seek Medical AttentionIf you experience any of the above warning signs of neuropathy, its essential to seek medical attention immediately. Early diagnosis and treatment can help prevent further nerve damage and improve overall outcomes. Diagnosis And TreatmentDiagnosing neuropathy involves a combination of medical history, physical examination, and diagnostic tests such as nerve conduction studies and electromyography. Identifying the underlying cause of neuropathy is crucial for effective treatment. Treatment options may include:Medications: Depending on the cause and severity of neuropathy, providers may preseribe pain relievers, anticonvulsants, and antidepressants to manage symptoms.Physical Therapy: Physical therapy exercises can help improve muscle strength, balance, and coordination.Lifestyle Modifications: Lifestyle changes, including managing blood sugar levels (for diabetic neuropathy), maintaining a healthy weight, and avoiding alcohol, can help slow the progression of neuropathy.Pain Management Techniques: Techniques such as acupuncture, massage, and transcutaneous electrical nerve stimulation (TENS) may provide relief from neuropathic pain.Underlying Condition Treatment: Addressing the underlying cause of neuropathy, such as diabetes or vitamin deficiencies, is essential to prevent further nerve damage. Its very important to start in the early stages of the diagnosis, said Dr. Santiago about neuropathy management. Keep A1c levels at seven or less. Fasting blood sugar at least at 130 mg/dl. Do exercise. Healthy diet.  Keep a good weight and take B complex with folic acid. Also, its very important to keep regular follow up with your PCP. Neuropathy is a complex and often debilitating condition that can have a significant impact on your well-being. By recognizing the warning signs of neuropathy and seeking medical attention as soon as you develop symptoms, you can take proactive steps to manage the condition and improve your quality of life. Prevention and early intervention are key to better outcomes and Better Health. Contact your primary care provider for proper evaluation, diagnosis, and guidance on managing your neuropathy. 

Whats Triggering Your Migraines?

If youre one of the one billion people worldwide suffering from migraines, you know the difference between a migraine and a headache. Many use the words interchangeably, but they are by far anything but the same. Headaches can be unpleasant but are often short-lived. Whereas migraines, on the other hand, can be excruciating, debilitating, and linger on for long periods of time. Anything from weather to hormones can trigger a migraine. But did you know that your migraine may be a result of something to do with your teeth? Its true. There is actually a strong connection between dental issues and the onset of migraines. So, how can dental issues cause migraines? Read on to learn more about their relationship. What Is A Migraine?Before we dive right into what dental issues may be causing your migraines and why lets first discuss what exactly a migraine is. The Migraine Research Foundation emphasizes that a migraine is more than a powerful headache  its a debilitating neurological disorder. Therefore, there are different symptoms and treatment approaches for migraines than other headache disorders. Symptoms vary by person but typically include: Severe or intense painPain may be on one side of the head or bothPain around the eyes and behind the cheeksThrobbing, pounding, or pulsating sensationPain gets worse with physical activity or any movementNausea and/or vomitingSensitivity to light, noise, and/or smellsPain prevents you from participating in regular, daily activities, such as workAttacks last anywhere from four hours to several days What Causes A Migraine?Many factors ranging from environmental to lifestyle, can trigger a migraine attack. One of the most common causes of migraines is genetics. If you have a family history of migraines, you are more likely to experience them yourself. Research has found that up to 80 percent of people with migraines have a family history of the condition. Hormonal changes are also believed to be a contributing factor to migraines. Women are more likely to experience migraines than men, and many women report that their migraines are linked to their menstrual cycles and/or menopause. Other potential triggers of migraines include stress, certain foods or drinks (such as alcohol or caffeine), and changes in sleep patterns. It is important to note that not everyone who experiences these triggers will develop migraines, and not everyone who experiences migraines will have the same triggers. Sometimes, your dental pain may even be mistaken for a migraine. When this occurs, its called referred pain. The Migraine-Tooth ConnectionReferred pain means that you feel a painful sensation in a different area of your body than the body part thats actually causing the pain. This occurs because of nerve connections, including from the trigeminal nerve. The trigeminal nerve is a cranial nerve responsible for controlling facial and eye movements and providing feeling to most of your face. Studies have linked the trigeminal nerve to the development of migraines. Orofacial refers to your head, neck, and oral cavity. All of those regions are closely connected and directly affect each other. One of the connections between your orofacial regions is the trigeminal nerve. Several orofacial conditions can trigger a migraine due to the trigeminal nerve connection. These conditions include: ToothacheA simple toothache caused by any number of dental issues, including untreated cavities, cracked teeth, or impacted wisdom teeth, can irritate the trigeminal nerve. This can lead to a migraine as the nerve can evoke intense sharp pains. BruxismBruxism or teeth grinding is a common culprit of a migraine. Often caused by stress or misaligned teeth, the act of grinding or clenching your teeth usually occurs at night and without you even realizing it. Headaches and migraines associated with bruxism typically cause a dull pain that wraps around the head and is also felt behind the eyes. A sore and tight jaw are also symptoms you may be grinding your teeth. In addition, the continuous grinding can cause nerve damage and irritation, thus radiating pain throughout your face and head. Temporomandibular Joint Disorder (TMJ)TMJ, or temporomandibular joint disorder, results when the ball and socket joint connecting your upper and lower jaw doesnt function correctly. The pain usually starts near the ear and moves toward the jaw, temple, or neck. Sometimes you can hear a popping sound when opening and closing your mouth; other times, your jaw may feel completely stuck. Alleviate Migraine Pain With Treatment And PreventionMigraines are no doubt painful and debilitating.  For temporary relief, you should take an over-the-counter pain reliever and ensure you get enough sleep and drink enough water. If you suffer from migraines, discuss your symptoms with your provider in addition to your dentist if you think it could be related to your teeth. Tooth pain, jaw pain, and headaches are all types of pain that you should speak to your healthcare provider about, as they could trigger a migraine. Never just ignore pain, as its your body informing you something is going on and needs to be addressed. It may be helpful to keep a migraine diary to track your symptoms and identify any potential triggers that may be contributing to your condition. This information can prove helpful for your provider when determining a cause and treatment plan

Local Services By This Author

Florida Gulf Coast Ear, Nose & Throat

Physicians 2180 Immokalee Road, Naples, Florida, 34110

Our family-friendly office offers a full spectrum of adult and pediatric diagnostic, therapeutic and surgical services for all problems involving the ear, nose, and throat.Our physicians, Samuel L. Hill, III, MD, FACS, FAAOA, Patrick M. Reidy, MD, Leela Lavasani, MD, FACS, Price Sonkarley, MD, FACS and Sue-Lay Plasencia, DNP, ARNP, NP-C, are Board Certified, fellowship trained specialists who are supported by a team of highly skilled medical professionals.

Florida Gulf Coast Ear, Nose & Throat

Hearing Services & Resources 2180 Immokalee Road, Naples, Florida, 34110

Our family-friendly office offers a full spectrum of adult and pediatric diagnostic, therapeutic and surgical services for all problems involving the ear, nose, and throat.Our physicians, Samuel L. Hill, III, MD, FACS, FAAOA, Patrick M. Reidy, MD, Leela Lavasani, MD, FACS, Price Sonkarley, MD, FACS and Sue-Lay Plasencia, DNP, ARNP, NP-C, are Board Certified, fellowship trained specialists who are supported by a team of highly skilled medical professionals.