L'ORL, l'expert des vertiges et des étourdissements
At the Clinique ORL, our ENT doctors, in collaboration with audiologists and hearing aid specialists, are able to help you understand, alleviate and treat your ear wax. We are one phone call away.
VERTIGO
Vertigo is an impression of rotational movement in space, and dizziness is a sense of instability. Vertigo or dizziness is a symptom, not a disease, and the two are sometimes difficult to differenciate for patients. Four categories of disease can cause vertigo or dizziness : neurological (due to the brain), otological (due to the ears), cardiac (because of low blood pressure) and psychiatric (anxiety or depression).
étourdissements sont une sensation d’instabilité. Le vertige ou l’étourdissement sont des symptomes et non pas des maladies, et ces symptômes sont parfois difficiles à différencier pour les patients. Pour les besoins de la cause, nous les nommerons tous vertige. Quatre catégories de maladies peuvent causer les vertiges : les maladies neurologiques (dues au cerveau), les maladies otologies (dues aux oreilles), les problèmes cardiaques (dues à des chutes de pression) et des maladies psychiatriques (anxiété/dépression).
The Otolaryngologist is well placed to accompany you in directing your care with vertigo or dizziness. History and physical examination by an ENT specialist are essential to identify the cause of your dizziness. Your doctor may send you for further testing such as an audiogram, a vestibulonystagmogram (VNG) or a magnetic resonance imaging study (MRI) of the brain.
étourdissements. Il est possible que le médecin vous envoie passer des tests
supplémentaires pour tenter d’identifier l’origine des symptômes. Les tests les plus
communément demandés sont l’audiogramme, le vestibulonystagmogramme (VNG) et la résonance magnétique cérébrale (IRM).
The ENT specialists at the Clinique ORL de Montréal are particularly well positioned to evaluate and treat vertigo.
Here are the most common causes of dizziness encountered by the ENT :
- Bening positional paroxystic vertigo (BPPV) : it is the most common cause of vertigo in all ages. BPPV causes vertigo lasting less than a minute while moving the head or during position changes in bed. It is treated with a repositioning maneuver called the Epley maneuver.
- Cervical dizziness : It is dizziness associated with neck pain or tension. The neck contains receptors that identify the position of the head in space (proprioceptors) and send a message to the brain. When a patient has neck pain or tension, a wrong signal is sent to the brain giving the impression of movement while the neck is not moving, thus causing dizziness. Cervical dizziness is treated with physical therapy, chiropractic adjustment, or osteopathic adjustment. Sometimes, vestibular rehabilitation is required.
- Vestibular neuritis : vestibular neurotis is inflammation of the nerve of balance, causing rotation dizziness that disappears by itself over a few days. The younger the patient is, the higher the likelihood complete recovery is possible. Vestibular rehabilitation is often necessary.
- Labyrinthitis : labyrinthitis is similar to vestibular neuritis, but is accompanied by hearing loss.
- Vestibular migraine : Vestibular migraine is under-diagnosed. It is characterized by 3 components that are (1) headaches or a history of migraines, (2) dizziness unexplained by the common causes of dizziness, and (3) disappearance of symptoms with anti-migraine medication.
- Ménière’s disease : Menière’s disease is caused by an increase in pressure in the inner ear fluids (endolymph). It is characterized by repeated bouts of hearing loss, tinnitus, and dizziness that last from 20 minutes to 24 hours. Many treatments are possible, such as avoidance of triggers, diuretic medication, or sometimes surgery.
- Vertebrobasilar insufficiency : Vertebobasilar insufficiency is a disease where bloodflow at the level of the brainstem is impaired during head rotation. It is a form of pre-stroke, called transient ischemic attack (TIA). It is discovered by imaging the vessels of the brain, and is treated by controlling risk factors and administering medication to thin the blood, like aspirin.
- Tumors : Certain tumors, like acoustic neuromas (auditory nerve tumors), can cause
hearing loss and dizziness, along with other brain-related symptoms. Your doctor
can diagnose these tumors with tests such as an audiogram and an MRI. The
management is either surgery, radiotherapy, or observation.
The ENT specialists at the Clinique ORL de Montréal are particularly well-positioned to evaluate and treat vertigo.
Guidelines
VPPB / BPPV AAO-HNS
Meniere’s AAO-HNS
Disease Migraine ICHD-3
- Sit by the window next to the wing in an airplane or on the front seat of a car where the sensation of movement is reduced.
- Concentrate on a point in the distance (distant landscape in a car or on the horizon on the deck of a boat if you are sailing).
- Do not read while traveling.
- Avoid strong odors or spicy or greasy foods before and during travel.
- Envisagez d'utiliser des médicaments en vente libre ou des traitements naturopathiques disponibles pour réduire le mal des transports (par exemple, Gravol, patch transdermiques, dérivés du gingembre).
- Stronger medications, such as sedatives, may be prescribed by your doctor.
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