When a doctor is presented with a patient experiencing a sudden onset persistent dizziness and/or balance disorder, the foremost task is to determine the underlying cause:
“whether it stems from the brain, or if it originates from the ear.”
When a patient with sudden onset severe persistent vertigo presents…
Accompanying symptoms such as muscle weakness, loss of sensation, inability to maintain balance, walking difficulties, speech disorders, coordination issues, facial paralysis, diplopia (double vision), and severe headaches suggest a central disease, such as a stroke brain tumor or multiple sclerosis attacks.
In the emergency room, a series of examinations known as HINTS (Head Impulse test, Nystagmus evaluation, Test of Skew) can be conducted quickly without medical equipment. If a central problem is suspected, imaging modalities are considered and neurologists play a vital role in its treatment. On the other hand, if the disorder is thought to be related to the inner ear, the patient is referred to ENT for further diagnosis and treatment.
In the ENT evaluation, first, an otoscopy is performed to check for any visible problems in the external ear or eardrum. The history of ear diseases, hearing loss, recent infections, and medication use are also inquired about. If hearing is normal and there are no symptoms of other diseases, "vestibular neuritis" is considered. Also, magnetic resonance imaging should be used to evaluate the inner ear and the 8th cranial nerve for potential underlying pathologies.
Vestibular neuritis can be successfully treated with symptomatic treatments, early mobilization, and vestibular exercises