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Dizziness

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An individual’s sense of balance well being occurs because the normal brain integrates normal signals from the ears, eyes and the muscles in the legs. Balance disorders can arise because of problems with any of these organs.

The most common source of balance disorders is an abnormality of the inner ear. There are two parts to the inner ear: the organ of hearing, the cochlea and the organ of balance, the labyrinth (comprised of the semicircular canals and utricle, see anatomy of the ear). The labyrinth tells a person their position in space. If a person turns around, that individual is aware of turning because the inner ear is being stimulated. If a person goes up in an elevator, that individual is aware of going up because the inner ear is being stimulated. When the inner ear does not work right, or is sick, there is a false sensation of moving. This is the definition of the word “vertigo,” the room spinning, the floor rocking. While vertigo is one of the most common complaints of patients with inner ear balance disorders, other common complaints include feeling “woozy,” “light headed,” “drunk,” “off balance,” “difficulty focusing,” or “spacey.” Balance disorders that arise from the inner ear are often associated with hearing loss, ear fullness or a noise in the ear (tinnitus). In order to evaluate an inner ear balance disorder hearing tests and balance tests (see….)are often necessary. Common disorders of the inner ear that cause imbalance include Meniere ’s disease and vestibular neuronitis.

The eyes are powerfully connected to the inner ear. When the inner ear is not working right, there is often an abnormal eye movement that the physician can observe called nystagmus. Conversely, many patients are sensitive to eye stress, such as scanning a computer or being in a room with surrounding motion and excessive visual stimulation, like walking down the isle of supermarket. Think of the person standing on the top of a tall building who feels like she is falling. That is the eye miscommunicating with the rest of the balance system. Think of the person sitting in a car or a train and an adjacent vehicle starts to go forward and he feels like he is going backwards. That is the eye miscommunicating with the rest of the balance system. Accordingly, poor or distorted vision often leads to imbalance.

All signals eventually come to the brain. Yet, the brain is not commonly the cause of imbalance. Migraine headache, a brain phenomenon, can be associated with dizziness or vertigo. There are rare seizure disorders associated with vertigo. An over accumulation of fluid surrounding the brain, hydrocephalus, can cause imbalance and difficultly walking. Brain disorders are often diagnosed with the help of a neurologist and the use of Magnetic Resonance Imaging scans, which are scanners that use no x-rays.

Read more about some common balance disorders here:

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