Vertigo & Balance Disorders

Reviewed by: [Name, MD – Board-Certified Otolaryngologist]

Affiliation: The Medical Group of New Jersey

Vertigo and balance disorders can be alarming and disruptive, causing dizziness, unsteadiness, nausea, and fear of falling. These symptoms may stem from inner-ear conditions, nerve inflammation, fluid imbalance, or chronic disorders affecting the vestibular (balance) system.

At The Medical Group of New Jersey, our ENT specialists provide comprehensive evaluation to identify the underlying cause of dizziness and offer targeted treatment to restore stability, confidence, and daily functioning.

Symptom Onset & Initial Evaluation

Vertigo may begin suddenly—as with benign paroxysmal positional vertigo (BPPV)—or develop gradually in conditions such as Ménière disease or vestibular neuritis. Common symptoms include:

• A spinning sensation (vertigo)
• Feeling off-balance or unsteady
• Nausea or vomiting
• Sensitivity to motion
• Ringing in the ears (tinnitus)
• Hearing changes or pressure in one ear
• Difficulty walking straight

These symptoms can fluctuate and may worsen with head movements, position changes, or sudden motion.

During your initial evaluation at The Medical Group of New Jersey, your ENT specialist will:

• Review when symptoms started and what triggers or relieves them
• Ask about recent infections, stress, injury, medication changes, or fluid/electrolyte issues
• Screen for migraine symptoms, which commonly overlap with vertigo
• Perform a focused ENT and neurologic exam
• Conduct positional testing (e.g., Dix-Hallpike maneuver) for BPPV
• Evaluate hearing, ear fullness, and pressure

The goal is to determine whether symptoms arise from the inner ear, the vestibular nerve, or another medical or neurologic condition.

Diagnosis & Risk Assessment

Accurate diagnosis helps guide effective treatment. Your ENT may perform or recommend:

Audiologic Testing

• Hearing evaluation: Identifies hearing loss associated with inner-ear causes like Ménière disease or labyrinthitis
• Tympanometry: Assesses middle-ear pressure or fluid buildup

Vestibular Testing

• Videonystagmography (VNG): Measures eye movements to evaluate balance pathways
• Rotary chair testing: Assesses inner-ear function and central processing
• Posturography: Evaluates stability and fall risk

Imaging & Additional Evaluations

• MRI or CT scan if a structural or neurologic cause is suspected
• Blood tests to rule out metabolic, thyroid, or autoimmune contributors

Common Risk Factors

Your ENT will assess:

• Recent viral infections
• History of migraines
• Previous head injury
• Ear infections or chronic ear disease
• Age-related vestibular decline
• Medication side effects (some antibiotics, blood pressure medications, sedatives)
• Autoimmune or metabolic diseases

This detailed assessment allows your ENT team to identify the root cause of dizziness and create a personalized care plan.

Treatment & Management

Treatment depends on the specific diagnosis and severity of symptoms. Many balance disorders respond well to targeted therapy.

Benign Paroxysmal Positional Vertigo (BPPV)

• Epley maneuver or similar canalith repositioning techniques
• Performed in the office to move displaced inner-ear crystals back into position
• Provides rapid relief for those that have BPPV based on Dix-Hallpike testing

Ménière Disease

• Focused on reducing fluid buildup in the inner ear: Low-sodium diet, diuretics, vestibular suppressants during acute attacks
• Steroid injections when needed
• Hearing support if progressive hearing loss occurs

Vestibular Neuritis or Labyrinthitis

• Treatment may include: Anti-nausea or vestibular suppressing medications (short-term use), steroids in select cases, gradual return to activity, and vestibular physical therapy.

Vestibular Migraine

• Management may involve: Migraine prevention medications, lifestyle modifications (sleep, hydration, trigger avoidance), and vestibular rehabilitation.

Chronic Imbalance or Age-Related Decline

• Balance and gait training
• Strengthening exercises
• Fall-prevention strategies
• Review of medications that worsen dizziness

Your ENT physician will explain each option to help you choose the safest and most effective treatment.

Monitoring & Follow-Up

Long-term follow-up is essential for managing recurring vertigo or chronic imbalance. Your ENT specialist may schedule:

• Reassessment after repositioning maneuvers
• Ongoing evaluation of Ménière disease symptoms
• Adjustments to medication or diet
• Repeat hearing tests for fluctuating hearing loss
• Coordination with neurology or physical therapy
• Balance assessments to prevent falls

Most patients benefit from periodic monitoring, especially if vertigo episodes recur or fluctuate.

With expert care from The Medical Group of New Jersey, most patients experience major improvement in stability and quality of life, often returning to normal activities with confidence.