Dizziness, a spinning sensation or balance problems can be related to changes in how the vestibular system of the inner ear works. Baltic American Clinic performs tests to find the cause of dizziness and help choose the right treatment.
Assessment by an otoneurologist (or an ENT doctor specialising in the diagnosis of dizziness).
Assessment of the balance system with clinical tests and specialised equipment.
A canalith (otoconia) repositioning manoeuvre can be performed when there are appropriate indications.
You can promptly schedule a consultation and the tests you need.
When should you see a doctor about dizziness?
A consultation is recommended if:
- Your surroundings spin. You feel that the room or your body is spinning even though you are not moving.
- You feel dizzy when you change head position. Symptoms appear when turning over in bed, lying down, getting up or tilting your head back.
- Your balance is impaired. When walking you feel unsteady, sway or tend to veer to one side.
- You have recurring attacks of dizziness. They last from a few seconds to several hours or longer.
- Dizziness comes with nausea. Especially if there is also a spinning sensation.
- You have hearing symptoms. Along with dizziness you have ringing in the ears, a blocked ear or reduced hearing.
- Dizziness interferes with everyday life. It is hard to work, walk or make ordinary movements.
Important. If dizziness started suddenly and comes with speech problems, weakness of the face or limbs, double vision, a new severe headache, or you cannot stand or walk on your own, call 112.
Which conditions can cause dizziness?
Benign paroxysmal positional vertigo (BPPV)
One of the most common causes of spinning dizziness (vertigo). Short, intense episodes of vertigo appear when you change the position of your head. The disorder is caused by otoconia – tiny calcium carbonate crystals – that have moved into the semicircular canals of the inner ear.
Vestibular neuritis
A disorder of the vestibular nerve that can cause sudden, severe and longer-lasting vertigo, nausea and loss of balance.
Ménière’s disease
An inner ear disease with recurrent attacks of vertigo, fluctuating hearing, ringing in the ears and a feeling of fullness in the ear.
Vestibular migraine
Episodes of dizziness related to migraine mechanisms. They can occur without a headache.
Persistent postural-perceptual dizziness (PPPD)
A long-lasting feeling of unsteadiness or swaying that can get worse when standing, moving or in surroundings with a lot of visual stimuli.
Other causes of dizziness
Dizziness can also be caused by changes in blood pressure, heart rhythm disorders, side effects of medicines or neurological diseases. Symptoms are not always related to the inner ear, so an assessment by specialists in other fields may be needed.
How is dizziness diagnosed?
During the consultation, the doctor asks when the symptoms started, how long they last, what triggers them, about other conditions and the medicines you take. Eye movements, balance and the function of the vestibular system are assessed.
If needed, vestibular function is tested with clinical tests or specialised equipment.
Assessment of spontaneous nystagmus
Involuntary eye movements that may indicate a vestibular disorder are assessed.
Head impulse test (HIT)
Helps to assess the function of the vestibulo-ocular reflex.
Head shaking test
Eye movements that appear after the head is moved are assessed.
Caloric test
The response of the vestibular system to temperature stimulation is assessed.
Positional tests
Help to determine whether dizziness is triggered by changes in head position, especially when BPPV is suspected.
Videonystagmography
Eye movements are recorded with specialised equipment, which helps to assess vestibular function more objectively.
Not every patient needs all the tests. The doctor chooses their scope according to your symptoms and the suspected diagnosis.
ENT examinationsTreatment of dizziness
Treatment depends on the cause found.
Canalith (otoconia) repositioning manoeuvre
Baltic American Clinic performs the otoconia repositioning manoeuvre to treat benign paroxysmal positional vertigo (BPPV).
During the procedure, the doctor changes the position of the patient’s head and body step by step to move the displaced otoconia back to the right place in the inner ear.
In some patients symptoms ease after one procedure, while others may need repeat treatment.
Treatment of other vestibular disorders
If Ménière’s disease, vestibular neuritis, vestibular migraine or another condition is found, the doctor chooses the next steps in treatment or recommends a consultation with another specialist.
Depending on the diagnosis, medicines, lifestyle changes or vestibular rehabilitation may be recommended.
How to prepare for dizziness tests
Before the consultation it helps to:
- Write down your symptoms. When the dizziness starts, how long it lasts and which movements trigger it.
- Bring previous test results. Especially hearing, neurological and vestibular tests.
- Tell us about the medicines you take. Some medicines can affect test results.
- Mention other conditions. Especially neck (cervical spine), neurological and cardiovascular conditions.
- Plan how you will get home. Some tests can temporarily make dizziness worse, so it may not be safe to drive.
You may receive additional preparation instructions before certain tests. Do not stop taking medicines on your own.
When may vestibular tests not be suitable?
The scope of testing may be adjusted because of neck (cervical spine) conditions, limited mobility, severe cardiovascular or neurological diseases, marked nausea or feeling generally unwell.
The doctor assesses the possible risks individually and, if needed, chooses a safer way of testing.
Frequently asked questions
Can dizziness be cured in one visit?
If the dizziness is caused by BPPV, the otoconia repositioning manoeuvre may help some patients after the first procedure. In other cases further treatment may be needed.
Can dizziness be related to migraine even if I have no headache?
Yes. Vestibular migraine can cause dizziness even without a headache.
Are vestibular tests painful?
Most vestibular tests are not painful, but some tests may temporarily cause dizziness, nausea or discomfort.
Can I drive after vestibular tests?
Some tests can temporarily make dizziness worse. If you feel dizzy after the test, do not drive.
Price of dizziness diagnostics
Prices for ENT consultations, vestibular function tests, videonystagmography and treatment procedures are set according to the Baltic American Clinic price list in force.
The consultation, tests and procedures are charged separately unless they are included in the price of a specific service. The scope of the tests needed and the expected costs are discussed during the consultation.