Balance and Dizziness

Good balance is dependent on nerve signals from healthy inner ears, eyes, legs being organized by the brain.

Dizziness is the disturbing sensation when balance goes wrong and can be due to abnormalities of inner ears, eyes, leg sensation or brain.



With over 20 years practice in the field of ENT, specialising in the treatment of dizziness and balance problems in Central London, I can help to determine why you are feeling dizzy and offer the best possible treatment. For details of my specialist ENT clinics at 150 Harley Street, The London Clinic at 5 Devonshire Place and The BUPA London Hospital, please click here, or contact me to schedule an appointment. 


Possible Causes of Dizziness


Benign Paroxysmal Positional Vertigo (BPPV) – “Crystals in the inner ear”

This is a very common cause of dizziness.


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Ménière’s disease

Ménière’s disease (pronounced “many-ears”) is a rare problem of the inner ear.

It is a repeating problem of the inner ear in which there is a build-up of fluid in the membranes of the inner ear giving a feeling of pressure or fullness in the ears. These membranes then suddenly burst making you feel very dizzy.


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What is Central Positional Vertigo (CPV) and why is it Important? 

Central Positional Vertigo (CPV) is a “dangerous and abnormal benign positional paroxysmal vertigo (BPPV)” because it can be caused by disease in the brainstem or cerebellum.


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Persistent Postural Perceptual Dizziness (PPPD) 

This is a common cause of dizziness. It has three main features: A long-standing complaint** of non-spinning “dizziness” on most days, association with anxiety and low mood and a normal clinical examination.


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Vestibular Migraine

Vestibular Migraine is an important cause of dizziness. The condition is most commonly characterised by nausea, a persistent headache which may be present only on one side of the head and a feeling of wanting to lie down in a dark room. 


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Vestibular Paroxysmia

This is a rare condition in which an artery presses on the nerve of the inner ear – either on the right or left side. 



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Vestibular Neuritis

Vestibular Neuritis is a common cause of prolonged dizziness due to injury of the inner ear. 



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Superior Canal Dehiscence

Superior Canal Dehiscence is a rare condition and one of a group of diseases which is caused by a ‘third mobile window’. It is due to an abnormal connection between the inner ear and the brain cavity. 



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Middle Ear Perilymph Fistula

Middle Ear Perilymph Fistula is a rare condition where there is a tear or hole in one or both of the small, thin membranes (the oval and the round windows) between the middle and inner ear resulting in a leak of perilymph into the middle ear.



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Advice and Medication

Here you will find some general advice and medication information for all dizziness related conditions other than BPPV. 



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Chiari Malformation in Adults

The fundamental cause of this condition is that the cerebellum is too big for the posterior fossa and is pushed down through the foramen magnum.




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Bilateral Vestibulopathy

Bilateral vestibulopathy (syn. bilateral vestibular areflexia) is a consequence of significant injury to the balance portions of both inner ears.



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Herpes Zoster Oticus (HZO) and Ramsey Hunt Syndrome (RHS)

These conditions are two forms of the same disease process where Ramsey Hunt Syndrome is Herpes Zoster Oticus with a facial nerve weakness.



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Motion Sickess and Persistent Sea Sickness 

Motion sickness, often called sea sickness, occurs when your brain receives conflicting signals from your eyes, inner ears, skin and joints about your state of motion. 




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The First Attack of Vertigo – Is it a Stroke or is it Inner Ear Disease? 

If vertigo first occurs with no pre existing history of dizziness both patient and clinician can be concerned as to whether this represents a Transient Ischaemic Attack (TIA/ Mini Stroke) which may herals the event of a more serious serious stroke with its devastating consequences. 



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