Can your ears make you feel dizzy?

When can a problem in your ears cause dizziness – and what can you do about it? We spoke to highly-trained consultant ENT surgeon Professor Owen Judd:

What are the possible causes of dizziness?

Dizziness is a symptom that is often quite difficult to describe. It can be felt as a sensation of light-headedness, a sensation of just not feeling right, through to a feeling as if one is about to faint, or that the world is spinning round. Therefore, not everyone experiences dizziness in the same way and for that matter have the same underlying cause.

Dizziness actually has a vast number of potential causes such as:

• side effects of medication
• dehydration
• hunger with low blood sugar
• inner ear or brain problems
• migraine

Dizziness can even be related to heart or blood pressure issues.

Is dizziness the symptom of an underlying condition?

In some cases, feeling dizzy can be just a simple reaction to being in too hot an environment, getting over excited, having exercised too much or not eaten or drunk enough water. However, dizziness if recurrent or persistent could be a sign of an underlying condition with the heart, blood pressure, brain or ears.

A common cause of dizziness is anxiety and panic which may mimic other causes and can often be frightening in itself. If dizziness occurs regularly or intensely, you should seek medical advice.

How does dizziness relate to the ears?

Around 40% of cases of dizziness may be related to the ears. The ears consist of three parts: the outer, middle and inner ear. Occasionally problems in the middle ear can cause dizziness but most commonly it is the inner ear that is the source of the symptom of dizziness.

The two inner ears, one on each side of the head, each contain five separate organs and these are essentially movement detectors. There are two parts called “otolith organs” which are designed to detect movement of the head against gravity i.e. movements in either a horizontal or a vertical plane, such as running forwards, falling, or going up in a lift.

There are also three other organs which are formed in loops called the semicircular canals. These are arranged at perfect right-angles to each other and are filled with a thin, watery fluid. These canals detect rotational movement of the head such as nodding, shaking your head from side to side or moving your head from shoulder to shoulder.

Between them these five organs on each side (ten in total) detect all movements of the head in any direction, and relay this information to the brain, so the brain can then tell what position your head is in and how it is moving. This is used to move your eyes around accurately when your head is moving to keep what you are looking at in crisp focus.

How does the inner ear cause dizziness?

As described, when we move our head the inner ears detect that movement and tells the brain how we have moved and when we have stopped moving. If however, we have problems with our inner ears, these movement detectors may malfunction – and tell the brain we are moving when we are not.

This false sensation that we are moving is a type of dizziness known as vertigo and is a typical type of dizziness symptom associated with an inner ear problem.

Most commonly, the sensation is one of feeling like your head or the world around you is spinning. Occasionally, however, people feel other abnormal sensations of movement such as swaying or bobbing up and down.

The inner ear also detects movement against gravity and so malfunction of these parts of the inner ear can lead to a feeling that you are falling, floating or that the world is catching up with you when you turn your head.

Finally, if the inner ear malfunctions it cannot help control the movement of our eyes as we move our heads. As a result we get abnormal eye movements called nystagmus as the brain tries hard to compensate for the ear problems.

How is dizziness evaluated?

Generally the cause of dizziness can be determined by a doctor taking a detailed history of the symptoms, such as listening carefully to your description of the episodes and asking questions about your symptoms and other health matters. The doctor may also examine you to determine the problem by listening to your heart, taking a blood pressure or checking your eye and face movements and watching you walk and perform certain movements.

Depending on the potential cause of dizziness there are a vast number of examinations or tests that may be used. These may include:

• testing the blood
• heart rhythm tracings
• serial blood pressure readings
• more sophisticated tests of the heart function or neurological system.

Scans such as CT or MRI scans may be required to help rule out certain causes.

If the dizziness is thought to be caused by the inner ear, there are many tests that are used. These include hearing tests and pressure tests for the middle ear. There are also tests to evaluate inner ear function such as:

• looking at eye movements with special goggles and cameras
• looking at the response to putting different temperature water or air into the ear
• looking at the response to certain movements of the body or head.

How is dizziness treated?

Treatment relates entirely to the cause of the dizziness in each individual patient. It may be something very simple – such as drinking more water or eating more regularly – or medical interventions such as medication or even surgery depending on the underlying condition.

In any case, the first aim is to make a diagnosis. Initial treatment is often then a trial of different options after discussion with you about the cause and the options available.

Lifestyle and diet changes are often used for many causes of dizziness and can have very dramatic effects without the need for more drastic treatment such as surgery or medication and the potential side-effects that may come with them.

Ultimately, treatment for dizziness is through partnership and collaboration with your doctor, where you will also take a part in making yourself better.

If you would like to speak to Professor Judd concerning dizziness symptoms, click here to book a consultation.