Dizziness

We are there for you when everything starts going round and round

I’m dizzy – most people already know this feeling from their childhood: After going on a merry-go-round, your surroundings often turn around for a short time, even though you are standing safely on solid ground. Or you get back to the shore after a longer boat trip and the land seems to sway. These types of dizziness are completely normal and usually stop quickly. But there are people who suffer a dizzy spell out of the blue. The attacks can also be accompanied by nausea, vomiting or unsteady walking and standing. 

At Schoen Clinic, we specialise in the diagnosis and treatment of dizziness. Using effective therapies, we eliminate the causes of your complaints and make you free of vertigo again.

Causes & symptoms

What is dizziness?

Dizziness is the feeling of movement when there is no movement, or a disturbed orientation in a given space. The information that the visual apparatus (eye) sends to the organ of balance in the ear does not fit together exactly with the information stored there. The brain cannot correctly process this contradictory information and can no longer represent the world the way it is. So, what is firm and solid suddenly becomes turning and staggering – in short: Feelings of dizziness develop.

A distinction is made between different forms of vertigo:
  • Staggering vertigo conveys the feeling that the ground is swaying under you like on a boat. 
  • In the case of rotary vertigo, the person affected feels like they are on a merry-go-round. 
  • With lifting vertigo, you have the feeling of being pulled up or down like in an elevator.
  • Numbness vertigo is often perceived as a strange feeling that is difficult to describe.

Causes: What triggers a vertigo attack?

Dizziness can be triggered in the brain or it results from a disruption of the organ of balance in the ear. Disturbances of the feeling perception in one’s feet can be expressed as dizziness. Causes for dizziness may, for example, also be blood pressure problems, anxiety, strokes, migraines, degenerative brain diseases, tumours, multiple sclerosis, or the side effects of medication. Here is an overview of the most common causes:
  • Benign positional vertigo
    It is the most common cause of short, violent vertigo attacks. They occur, for example, when patients turn over in bed in the morning. They are triggered by small crystals in the organ of balance. This vertigo responds very well to treatment.
  • Vestibular paroxysmia
    In this disease, a blood vessel rubs against the balance nerve and triggers brief attacks of rotary vertigo. The attacks can easily be suppressed with medication.
  • Migraine and Ménière’s disease
    Long-lasting vertigo attacks are usually the result of migraine or Ménière’s disease. In Ménière’s disease, ear pressure and ringing in the ears lead to dizziness. Both diseases respond well to treatment.
  • Neurological diseases
    A sudden and violent vertigo attack, which lasts for hours and is accompanied by rotary vertigo, nausea and vomiting, can also indicate a stroke. Immediate action is required here. Prolonged dizziness with unsteady gait can also indicate a neurological disease such as cerebellar ataxia, Parkinson’s, Alzheimer’s or multiple sclerosis.
  • Inner ear disorders
    Dizziness lasting for months or years may indicate the failure of both balance organs. Viral infections, such as middle ear infection, can lead to the loss of one organ of balance. Violent rotary vertigo can occur.
  • Anxiety disorders or depression
    Even if anxiety or depression trigger the vertigo attacks, this usually responds well to treatment. 

Symptoms: What dizziness symptoms occur?

Symptoms of dizziness vary greatly. They range from briefly seeing stars to swaying for hours and a persistent feeling of dizziness (permanent dizziness). The dizziness is often accompanied by other complaints such as drowsiness, nausea, vomiting, impaired vision, sweating or ringing in the ears.

Diagnostics

Diagnosis: How we diagnose dizziness

The first and most important diagnostic step is the patient consultation. As a rule, our experienced specialists can already limit the problem using information on the time, frequency and duration of the complaints.

Ideal: the vertigo diary

An exact description of the attacks is important. Ideally, you should keep a vertigo diary before your visit and list the following points: first appearance, duration, trigger, accompanying symptoms and type of vertigo (rotating, staggering, feeling of being lifted or numbness). Thus, in most cases, a suspected diagnosis already arises in the first consultation. Following this, various tests help us to specify the cause.

Video-oculography

Many dizzy spells occur when the interaction between the eyes and the organ of balance is disturbed. Normally, a reflex ensures that every movement of the head is balanced by the eyes. If this reflex doesn’t work, the world appears shaky. Video-oculography is a special procedure for examining eye movements and the balance system.

The “subjective vertical”

Various balance and movement tests show whether your subjective idea of “vertical” corresponds to reality. If you consider “tilted” to be “straight”, the cause of the vertigo usually lies in the balance system in your brain or the ear.

Gait analysis and posturography

Dizziness often goes hand in hand with unsteady gait and a risk of falling. Movement disorders can be classified precisely by means of a gait analysis. Posturography is used to determine the swaying of the body. This is measured when standing on a special platform with the eyes open and closed.

Imaging procedures

If a neurological disease is suspected, we usually use an imaging procedure such as magnetic resonance imaging (MRI).