Professor Henry Pau
Professor Henry Pau is a Consultant Ear Nose and Throat Surgeon who practices at Spire Leicester Hospital and the University Hospitals of Leicester. He has written several book chapters and published numerous papers in international medical journals. His biography is published in "Who's Who in Medicine and Healthcare" and "Who's Who in the World".
Dizziness and Balance Disorders
"Dizziness" or "vertigo" means a sensation of spinning and is a common medical problem. It is usually caused by inner ear diseases such as Meniere's Disease but occasionally can be due to brain disorders including multiple sclerosis. Some dizzy patients present with other symptoms including deafness, tinnitus, spinal problems, headaches and visual disturbances. When assessing patients with balance problems, one should be clear on how the patient feels exactly. Some patients may describe "dizziness" as being light headed and these patients are more likely to have heart, blood pressure or blood vessel diseases. Dizziness can affect all groups but it is more common in adults.
Vertigo caused by inner ear diseases
This condition was first described by a French Physician, Dr.Prosper Meniere, in 1861. Patients typically present with vertigo, fluctuating deafness, tinnitus and a sensation of fullness in the ear. This can be a very disabling condition and is thought to be caused by excessive fluid in one of the chambers within the inner ear. Initial treatment should concentrate on reducing the fluid by restricting salt and caffeine intake and using diuretics and vasodilators. Should medical treatments fail, depending on the severity and nature of the individual's condition and hearing levels, some patients may require surgery including grommet insertion, saccus decompression (reducing pressure in the inner ear by complex ear surgery) and chemical labyrinthectomy using gentamicin and steroids (injections into the ear).
Any viral illness including a common cold could cause labyrinthitis. Patients experience severe vertigo and nausea, and treatment should include fluid support and a short course of labyrinthine sedatives like stemetil.
Benign Paroxysmal Positional Vertigo (BPPPV)
BPPV is caused by loose calcified crystals within the inner ear which can be a result of whiplash injuries, head injuries or viral infection of the inner ears. Symptoms of transient vertigo, which normally last for a few seconds, are brought on by movements of the head especially when patient is lying flat. Treatment is normally by Epley manoeuvre, a form of physiotherapy and very rarely, patients may require surgery.
Vertigo caused by central/brain disorders
This is a rare form of migraine presenting with aura, headache, photophobia and vertigo and can be treated successfully by anti-migraine tablets.
When the patient's symptoms are unusual or one-sided, an MRI scan of the brain should be performed to exclude central problems including acoustic neuroma, multiple sclerosis and other brain lesions.