Dizziness, Vertigo and Motion Sickness
Each ear more than two million people visit a doctor for dizziness or vertigo, and an untold number suffer with motion sickness, which is the most common medical problem associated with travel. The symptoms of motion sickness, vertigo, and dizziness appear when the central nervous system receives conflicting messages from the body’s balance receptors: the inner ears, the eyes, and the muscles down the back and soles of the feet.
While most cases of dizziness and motion sickness are mild and self-treatable, severe cases, vertigo, and balance disorders that become progressively worse deserve the attention of a physician with specialized skills in otology and neurotology, such as Dr. Chandrasekhar.
Some people describe a balance problem by saying they feel dizzy, lightheaded, unsteady, or giddy. This feeling of imbalance or dysequilibrium, without a sensation of turning or spinning, is sometimes due to an inner ear problem.
The word vertigo, which comes from the Latin verb “to turn”, is used by people who experience that they or their surroundings are turning or spinning. Vertigo is frequently due to an inner ear problem.
Some people experience nausea and even vomiting when riding in an airplane, automobile, or amusement park ride, and this is called motion sickness. Motion sickness experienced when riding on a boat is called seasickness.
Motion sickness or seasickness is usually just a minor annoyance and does not signify any serious medical illness, but some travelers are incapacitated by it, and a few even suffer symptoms for a few days after the trip.
Many medical conditions can cause dizziness. The dizziness that is not otologic (ear-related) is usually more constant and less episodic or positional in nature, and is often associated with other symptoms that aid in the proper diagnosis. Causes include:
Circulation (such as lightheadedness), seen with heart or artery disease, after ingestion of certain agents such as nicotine, caffeine, and excess salt, and with emotional stress.
Allergy: Some people experience dizziness and/or vertigo attacks when they are exposed to foods or airborne particles (such as dust, molds, pollens, danders, etc.) to which they are allergic.
Neurological diseases: A number of diseases of the nerves can affect balance, such as multiple sclerosis, syphilis, tumors, etc. These are uncommon causes, but your physician will think about them during the examination.
The doctor will ask you to describe your dizziness, whether it is light headedness or a sensation of motion, how long and how often the dizziness has troubled you, how long a dizzy episode lasts, and whether it is associated with hearing loss or nausea and vomiting. You might be asked for circumstances that might bring on a dizzy spell. You will need to answer questions about your general health, any medicines you are taking, head injuries, recent infections, and other questions about your ear and neurological system. Dr. Chandrasekhar will examine your ears, nose, and throat and do tests of nerve and balance function. Because the inner ear controls both balance and hearing, disorders of balance often affect hearing and vice versa. Therefore, you will probably undergo hearing tests (audiograms, otoacoustic emission tests (OAE), auditory brainstem response tests (ABR)) as well as special tests of inner ear balance and fluid function (Electronystagmography (ENG), electrocochleography (ECoG), vestibular evoked myogenic potential (VEMP), rotary chair test, posturography evaluation (CDP)). The physician might order a CT or MRI scan of your head, or blood tests or a medical or visual evaluation might be recommended. Not every patient will require every test. The physician’s judgment will be based on each particular patient. The treatments recommended by Dr. Chandrasekhar will range from rehabilitation to diet modification to medicine to surgery, and will depend on the diagnosis.
What Can I Do For Motion Sickness?
Always ride where your eyes will see the same motion that your body and inner ears feel, e.g. sit in the front seat of the car and look at the distant scenery; go up on the deck of the ship and watch the horizon; sit by the window of the airplane and look outside. In an airplane choose a seat over the wings where the motion is the least.
Do not read while traveling if you are subject to motion sickness, and do not sit in a seat facing backward. Take one of the varieties of motion sickness medicines or pressure bands before your travel begins, as recommended by your physician.
(adapted from http://www.entlink.net/healthinfo/balance/dizziness.cfm)
You can read more about dizziness in Dr. Chandrasekhar’s published works, including:
- Lee H-J, Lum C, Means K, Chandrasekhar SS, Brown L, Holodny A: Temporal Bone Fractures and Complications: Correlation between High-Resolution Computed Tomography and Audiography. Emerg. Radiol. 1998;5(1):8-12.
- Koenigsberger MR, Chandrasekhar SS: El nino con mareos. Rev Neurol (Barc) 1995;23 Suppl 3:S410-7.
- Chandrasekhar SS: Office treatment of benign paroxysmal positional vertigo. In: Office Techniques in Otolaryngology – HNS, Krespi, Blitzer, Jahn, editors.
Another useful site is www.vestibular.org.