In July, UI Health Care opened a Balance Disorders Clinic, one of the few in the country. The new clinic is a joint effort of the neurology and otolaryngology departments and is directed by Deema Fattal, MD, one of about a dozen neurologists in this country trained to evaluate dizziness.
"Although rarely strokes can cause dizziness, most of the time, the reasons for dizziness are relatively mild," Fattal said. "Migraine headaches are a common cause of dizziness. Other common causes are viral infections, Ménière's disease which affects the inner ear, and a relatively common and benign condition primarily in the elderly known as benign paroxysmal positional vertigo, often referred to as loose stones."
Everyone has tiny stones located in the inner ear. If these stones break loose and wind up in the ear canal fluid, they can cause dizziness. Treatment consists of placing the patient in bed and turning them in a certain way that puts the stones back into their proper place, according to Fattal.
"Usually dizziness is mild and will disappear with proper treatment," she said. "Some people go for years with a dizziness problem because they weren't treated properly or were diagnosed incorrectly. The main milestone for treatment is balance therapy which includes exercises to improve balance."
Fattal explained that a person's balance system is located in the ears, which send signals to an integrating center in the brain. "If there is an imbalance in the signals because one of the ears is malfunctioning, dizziness will result. In time, however, the brain will compensate for the disorder and the dizziness will usually go away."
Sometimes, however, the dizziness does persist. "One reason for this is migraine headache. If patients take a medication to decrease the dizziness, this often deters the ability of the brain to compensate. Also, if patients become inactive because of their dizziness, they also tend to lose the ability to compensate," she said.
That's why balance therapy is a very important treatment. Fattal compared balance therapy to physical therapy, using a broken arm as an example. She explained, "If you break an arm and put it in a cast for six weeks, it comes out shrunken. The only way you can get it back to work is to exercise it. It's the same thing with the signals from the ear. Your balance and dizziness will become worse and worse if you don't exercise them."
Fattal says the risk for dizziness rises with age. She recommends that patients visit their health care provider any time they become dizzy without apparent cause. For additional information, call Fattal at 319-356-8753 or e-mail deema-fattal@uiowa.edu.
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