common cause of dizziness vestibular disorders

Vestibular Disorders: A Common but Under-Recognized Cause of Dizziness

In support of the Vestibular Disorders Association (VEDA) balance awareness week, this post aims to increase the awareness of vestibular disorders and the potential impact of a vestibular disorder on one’s life.

Dizziness symptoms are common with an estimated annual prevalence of 33 million individuals in the United States. Symptoms of dizziness can arise from a multitude of etiologies; however, peripheral vestibular disorders are extremely common accounting for around 44% of all dizziness complaints. That suggests that around 14.5 million individuals in the United States alone suffer from a peripheral vestibular disorder annually. Compared with 1.5 million new diagnoses of Diabetes in adults in the year 2015 according the Center For Disease Control, it shows the magnitude of peripheral vestibular disorders.


Understanding Vestibular Disorders


Vestibular disorders tend to produce symptoms of vertigo, meaning a false sensation of self or environmental motion, but individuals may also have symptoms of imbalance, disorientation with head movement, rocking or tilting sensations. These symptoms of dizziness are frequently accompanied by nausea and vomiting, but may also present with concomitant changes in hearing or tinnitus.

Peripheral vestibular disorders can often times be effectively treated with either repositioning maneuvers or vestibular rehabilitation therapy to promote recovery. Therefore, it is paramount that correct identification of the specific disorder is made so that appropriate treatment can be rendered.

Despite being a common cause for dizziness symptoms, vestibular disorders have historically been under recognized and poorly managed leading to symptom chronicity, disability, activity limitation and reduced quality of life. This lack of knowledge and poor management of vestibular disorders is likely attributed to frontline providers needing to rule in or out worrisome pathologies such as stroke or heart attack, leaving benign peripheral vestibular disorders as an afterthought.

For accurate assessment of vestibular disorders, equipment such as infrared video goggles are helpful, but are often times a luxury that these providers do not have. Also, the limited number of specialists available makes diagnosis and treatment difficult even when a peripheral vestibular disorder is suspected. 

How can we combat this history of lack of awareness, poor management and treatment of peripheral vestibular disorders? We can increase public awareness of vestibular disorders with patients and those in our community. We can encourage inter-professional collaboration in fields including but not limited to Audiology, Physical Therapy, Occupational Therapy, Internal Medicine and Emergency Department providers on how to appropriately identify and manage these patients. We can develop means to adequately and in a timely manner determine which patients are appropriate referrals for vestibular assessment, with an aim to reduce the burden on primary care providers and aid in efficient diagnoses for dizzy patients, as some are currently working on.



About Brady Workman

Brady Workman, AuD, is an audiologist in the Balance Disorders program at Wake Forest Baptist Health Center. Brady resides in Winston-Salem, North Carolina and is licensed by the North Carolina Board of Examiners for Speech Language Pathologists and Audiologists and is a fellow of the American Academy of Audiology. His primary clinical interests include comprehensive vestibular assessment and adult hearing diagnostics.