ear, nose, and throat disorders
Dizziness and Vertigo
Etiology of Dizziness and Vertigo
There are numerous structural (trauma, tumors, degenerative), vascular, infectious, toxic (including drug-related), and idiopathic causes (see table), but only a small percentage of cases are caused by a serious disorder. Themost common causes of dizziness with vertigoinvolve some component of the peripheral vestibular system: Benign Paroxysmal Positional Vertigo None Meniere Disease None Vestibular Neuronitis None Purulent Labyrinthitis None Other causes include a central vestibular disorder (most commonly migraine), a disorder with a more global effect on cerebral function, a psychiatric disorder, or a disorder affecting visual or proprioceptive input. Sometimes, no cause can be found. Themost common causes of dizziness without vertigoare less clear cut, but they are usually not otologic and probably are Drug effects Multifactorial or idiopathic Nonneurologic disorders with a more global effect on cerebral function sometimes manifest as dizziness and rarely as vertigo. These disorders typically involve inadequate substrate (eg, oxygen, glucose) delivery caused by hypotension, Oxygen Desaturation , Occasionally, dizziness and vertigo may be psychogenic. Patients with Panic Attacks and Panic Disorder , Persistent perceptual postural dizziness (PPPD), sometimes described as chronic internal swaying that goes away when lying flat and lasting for over 3 months with no clinical explanation for its persistence, is classified as a chronic functional disorder. It can be precipitated by other acute conditions, such as Benign Paroxysmal Positional Vertigo or vestibular migraine, or can be a manifestation of an Uncompensated peripheral vestibular weakness causes dysequilibrium rather than vertigo and often visual blurring with head turning. It can be the result of vestibular neuronitis, migraine with vertigo, Meniere disease, head trauma or inner ear surgery. In older patients, dizziness is often multifactorial secondary to drug adverse effects and age-diminished visual, vestibular, and proprioceptive abilities. Two of the most common specific causes are disorders of the inner ear: Benign Paroxysmal Positional Vertigo and 