Balance & Dizziness: Causes, Symptoms, Diagnosis & Treatment

Overview

Vertigo isa feeling that you or your surroundings are spinning or moving when you are not. Vertigo can cause dizziness and a loss of balance.It can be caused by problems with the inner ear (peripheral vertigo) or the brain (central vertigo).Dizziness is a general term that encompasses loss of balance, lightheadedness, a spinning sensation or an inability to walk straight, among other symptoms. It can be caused by problems in the inner ear, brain, eyes, or neck, and sometimes involves multiple causes. For people affected by vertigo or dizziness, receiving an accurate diagnosis that identifies the cause of the symptoms is vital to be able to return to normal life.

The Balance Center at Cleveland Clinic Abu Dhabi offers specialized, patient-centered care for people suffering from dizziness, vertigo, Meniere’s disease, vestibular migraines and other complex balance-related disorders. As one of the only specialized Balance Centers in Abu Dhabi, we provide patients with streamlined access to integrated diagnostics, expert care, and rehabilitation, all in one place, without the need for multiple referrals.

Our multidisciplinary team, including ENT specialists, audiologists, and physical therapists, work together to deliver comprehensive, personalized treatment. We use state-of-the-art diagnostic testing, to accurately diagnose balance issues and design targeted, effective care plans. Every patient is different, and so is their treatment. Whether it’s vestibular therapy, medication, or lifestyle guidance, we customize care to deliver long-term relief and real results, helping patients regain stability and improve their quality of life.

What we treat

The Balance Center treats patients with the following conditions:

Dizziness
Vertigo
Meniere’s disease
Benign paroxysmal positional vertigo/BPPV (inner ear crystals)
Labyrinthitis
Neuronitis
Vestibular migraine
Post-viral vestibulopathy
Superior semicircular canal dehiscence syndrome
Autoimmune inner ear disease
Vestibular schwannoma

Diagnosis & Treatment

An accurate diagnosis of the cause of vertigo, dizziness and other balance conditions is key to successful treatment, and to returning to a normal life quickly. When you visit the Balance Center, you will initially be assessed by our otologists, who will obtain a detailed history of your symptoms and conduct a thorough physical examination. Based on this, they will then order tests that assess the hearing and balance functions of the inner ear.

The most common tests to assess the inner ear function as well as the balance system in general include:

Video-nystagmography (VNG): Utilizes infrared cameras to record eye movements, helping to evaluate the vestibular function of the inner ear and identify central (brain-related) components of dizziness.

Computerized dynamic posturography (CDP): Originally developed for NASA, this technology assesses a patient’s balance by measuring responses to various movements. It provides objective data to help determine the root cause of chronic dizziness.

Video head impulse testing (vHIT): This is a test that evaluates the inner ear balance function by examining the semi-circular canals.

Vestibular evoked myogenic potential (VEMP): This evaluates the inner ear balance function by examining the saccule and utricle. There are two types of VEMP test: Cervical VEMP (c-VEMP) or Ocular VEMP (o-VEMP).

Electrocochleography (EchoG): A specific test that measures small electrical waves within the inner ear in response to sounds. It is easy to administer and can give good indications about the presence of Meniere’s disease.

Rotational chair testing: This helps us to differentiate between inner ear and brain causes of dizziness or vertigo

In addition to Balance Tests, your doctor may request imaging tests, such as an MRI of the inner ear, brain, or spine. Following a thorough assessment and discussion by the whole team, a treatment plan will be offered to you. This may include a combination of medical treatment and vestibular rehabilitation therapy, a specialized form of physical therapy focused on improving your balance.

Vestibular Rehabilitation Therapy (VRT)

Vestibular rehabilitation therapy (VRT) is a specialized form of therapy provided by physical therapists that is intended to alleviate problems caused by inner ear disorders, primarily vertigo and dizziness, gaze instability, and imbalance. A comprehensive evaluation will be performed by our physical therapists to first assess the type of problems that vestibular disorder is causing. A follow-up session and customized exercise program will then be given which will focus on improving balance. Three types of exercises are usually prescribed:

Habituation: This type of training involves repeating the movements that cause dizziness.

Gaze Stabilization: This type of exercise improves eye control during head movements.

Balance training: These exercises are used to improve steadiness during various daily activities that require standing and walking on uneven surfaces, and in the dark, without losing balance.