Vestibular Conditions

Common Dizziness/Tinnitus Conditions: Learn about it!

I work with many vestibular, autoimmune and neurological conditions.  Here is a list of some common conditions that my clients experience.  If you are unsure about your diagnosis or it is a rare condition, please book an initial consult to discuss getting support for your symptoms.

In this page you will find information and audio links about:

And some less common dizziness conditions, including:

Finally, learn about:

Read the information below (or listen to the audios to rest your eyes) to be informed about what our ears, brains, and bodies are experiencing during dizziness. This can be really valuable to help with your recovery.  

Read the article: ‘5 Common Misunderstandings About Vertigo’ here.

What is vertigo and tinnitus?

Vertigo is a sensation of movement when we are not moving. Tinnitus is a sound that we hear within our ears, head or body that is unrelated to the external environment.

In order to re-establish balance, we need to rewire the internal system.  This subtle process takes into account aspects of our physical, mental, emotional and spiritual wellbeing.  We create gentle daily steps, actions and tools for each part of our ‘wholeness’.

Without support or a specific plan, people can feel stuck in sensations of dizziness/tinnitus. 

Use our resources to learn more about your condition and how to create your own holistic plan for a neuroplasticity based recovery.

Benign Paroxysmal Positional Vertigo (BPPV)

Listen (7 minutes)

Key points: non-harmful, intermittent, positional, brief spinning, treatable. You can treat this at home safely and effectively with the BPPV Video Kit. Contact a local vestibular expert to help you diagnose and treat this condition if it persists.

What is it?

BPPV is a commonly seen form of dizziness. It is a condition of dislodged calcium carbonate particles inside the inner ear. The particles belong in neighbouring areas of the inner ear and are important for detecting acceleration movements such as starting and stopping. However, in this condition, some particles fall out of the area they belong to and cause annoyance in adjacent areas of the inner ear. BPPV can affect anyone, at any age. It is more common than we think. In our University of Melbourne office, 4 out of 16 people have had BPPV.

The situation:

The particles have moved into one of the semicircular canals of the inner ear where they do not belong. This is a problem because now when we move our head, such as rolling over in bed, the particles create a strong sensation of vertigo. As the head rolls in bed, the particles also move within the balance canal creating a vertigo response until they can resettle themselves somewhere less annoying. The vertigo will be triggered each time we make a head movement that shifts the crystals around the semicircular canal.

What might it feel like?

You will see the world spin around distorting your vision when you move your head in a certain position (e.g. rolling over. bending down or looking up). This spinning is a brief form of vertigo and may occur with a lingering sense of nausea or shock. Symptoms are transient and generally pass in less than a minute.

What can I do about it?

Particle repositioning treatments are simple and straightforward. These can be done at home, however if you are anxious about symptoms please seek treatment from a specialist. Ask your vestibular audiologist, physiotherapist or General Practitioner if they know how to do the treatment. Find a vestibular specialist to assess your ‘nystagmus’ eye movement.

If you live remotely, or cannot find someone locally- use the BPPV Video Kit. We can take you through the BPPV treatment steps remotely with video demonstrations.  You don’t need to do it alone 😉  Finding a local person to support you would be preferable (but not always possible, we understand).

The Epley manoeuvre is most commonly performed to treat this condition, and has a success rate of around 80%. Treatment can be repeated twice daily until the condition resolves. BPPV may be intermittent and may recur for no known reason. Excessive treatments can further dislodge particles and create ongoing symptoms. The Brandt-Daroff exercises can make the BPPV more difficult to treat!

BUT … Why do I have persistent BPPV?

Most commonly, BPPV comes from loose particles in the posterior semicircular canal. When the particles are free-floating, this is called canalithiasis and is usually treated effectively. However, there are exceptions and some BPPV can persist or be difficult to treat. 

This can occur when:

  • Both ears are affected
  • The calcium carbonate particles become adhered to the inner part of a balance canal, making it difficult to reposition them (referred to as cupulolithiasis BPPV)
  • Or the particles are found in one of the less common semicircular canals

These rare types of BPPV may require treatments other than The Epley.  You can learn more about treating difficult BPPV in The BPPV Video Treatment Kit. It is best to only treat one ear at a time, so repeat treatments about one week apart may be required until symptoms resolve in each ear.

I have seen patients who have had BPPV for over 20 years without treatment (not all doctors or health professionals are trained in this treatment process.)  Since effective BPPV treatment in clinic, they are now completely free of their vertigo. 

Try the ROCK STEADY Program for access to FULL BPPV video demonstrations and further information about preventing ongoing vertigo, dizziness or anxiety. 

Labyrinthitis (inner ear infection)

Listen (3 minutes)

Key points: It is not recurrent, usually only in one ear, vertigo is severe at onset and gradually improves over the following months, hearing loss or tinnitus noises may also occur, medical advice recommended.

What is it?

Labyrinthitis is a viral or bacterial bug that causes disruption inside the inner ear. If it is contained to the balance organs alone, then vertigo will be the main concern. If the infection spreads to the hearing organs then hearing loss and new noises (tinnitus) within the ear/s may also be noticed.

The situation:

The infection can cause trauma to the inner ear structures resulting in permanent damage to the fragile architecture of the inner ear. Luckily, we have two ears, so if one ear is damaged we can still use the balance and hearing functions on the other side. The recovery process is different for each person. The body and brain need to re-learn how to balance and hear with only one ear. This can be confusing, frustrating, and tedious.

With ROCK STEADY support tools and home exercises, recovery can be a smooth process.

Meniere’s Disease or Endolymphatic Hydrops

Listen (7 minutes)

Key points: Episodic vertigo, spinning for longer than 20 minutes, fluctuating hearing loss/ tinnitus/ aural (ear) fullness, usually only one ear is affected, medical investigation recommended.

What is it?

Meniere’s disease is thought to be a combination of environmental and genetic factors. It is not something that we can predict, prevent or control, but we can support healthy recovery and prevent ongoing stressors. Meniere’s episodes can result in permanent damage to the inner ear structures resulting in balance symptoms and permanent hearing loss in that affected ear.

The situation:

For Meniere’s patients, the inner ear makes too much special inner-ear-fluid (known as endolymph). In fact, it can make so much fluid that the inner ear no longer has enough space to store it. Part of the inner ear membranes may then rupture causing a mix of inner ear fluids. The mix of fluids can damage the balance and the hearing organs.

The body and brain then need to rebuild membranes and balance and hearing pathways during the recovery process. This can be a very tender and sensitive time. Patients may report feeling sensitive to both sound and movement. It can be a confusing and exhausting process over months, or it may recover in just a few days.

The amount of fluid produced, stored, and used by the inner ear is not effectively controlled by medicine. Meniere’s attacks can be very unpredictable. Each person has a different experience of vertigo/hearing loss and the uncertainty of symptoms can feel quite debilitating. Having tools and strategies for strengthening steadiness can be very useful.

It is helpful to have ROCK STEADY support tools and action plans for effective recovery. Ongoing stressors and persistent worry can exacerbate the vertigo. Our body can recover its balance function following a Meniere’s attack – stay supported.

Vestibular Migraine

Listen (7 minutes)

Key points: Pressure, fullness or pain in the skull (not specifically in the ears), light/sound sensitivity, motion sickness, episodic vertigo for more than a few minutes, nausea, medical advice recommended.

What is it?

Vestibular migraine (VM) is not an ordinary migraine. It is a condition that is characterised by a cluster of symptoms that may or may not include headache! Symptoms may include vertigo, tinnitus, hearing distortions, visual distortions, motion sickness, sensitivity to light/sound, headache and brain fog. Or put quite simply, people with VM often report that they feel not-quite-right. VM symptoms can vary as time goes on, people can ‘grow out of it’ or it may grow with you changing each year.

The situation:

The rhyme and reason of vestibular migraine is not entirely understood. There are some ideas, symptoms may be related to a variable supply of oxygen and blood sugars due to either an excess of blood flow around the brain and inner ears (like a tap running with a full stream of water flow) or due to a restriction of blood flow around these regions (like a tap with a slow and thin stream of flow). Either way, the ears and the brain prefer to have a STEADY stream of oxygen and blood sugar supply, so neither are optimal and could result in distorted sensations. Another explanation is that the neural communication fibres connecting the limbs, ears, eyes, and all of our body parts to the brain are in a state of confusion, as though there is a big traffic jam slowing down the information as it travels from one place in the body and brain to the next.

There is no clear explanation. VM may be partly environmental and partly genetic. It may be triggered by stress, fatigue, emotional upsets, allergies, life changes, traumas, hormonal changes or other factors. Each person has a different VM story to tell. Many people with VM report anxiety and lingering symptoms of feeling not-quite-right between attacks despite normal hearing and balance function.

It is really useful to have support tools and strategies for preventing overwhelm. I have seen many VM patients who, after having been medicated for this conditions for decades, are now symptom-free and able to manage their early warning signs without medications.  They have returned to confidence. Everyone has a different road to recovery. Awareness of your changing “needs” is key. Explore what your body is asking for to help it recover.  

Consider physical, mental, emotional, and spiritual aspects of your life. Try the ROCK STEADY 12-week online support program or 1:1 sessions to focus in on your process. Support all of you.

Remember, if it were ‘easy’ to understand, we would have it all sorted out by now.  Give yourself time and kindness to explore this at your own pace.  You can feel better.

Brain Fog, Fuzziness, Idiopathic Dizziness

Listen (3 minutes)

Key points: It can feel like a jetlag that doesn’t end.

What is it?

This is a cluster of symptoms that do not quite fit into any other category. Patients report feeling off-kilter or they report lingering sensory distortions. There are no known triggers. Patients often note reduced concentration, visual blur or brief dizzy spells. The sensory distortions can occur when the pathways to and from the brain are a little muddled. With medical clearance, there is a great possibility that these symptoms will mend with time and understanding of what our body is telling us. The symptoms often make sense once we really listen in, with openness and curiosity.  We lean in.

The body is always seeking its own symmetry, homoeostasis and equilibrium. It can take time and it can be frustrating.

Many patients with these symptoms make subtle changes to their priorities and look for ways to recharge their batteries. In other words, when all else fails, look to self-care strategies and find out what works for you… the options are endless.  We have seen people recover (& thrive) time and time again.

You know it… Being overworked, under-slept and spending lots of time in front of a screen or on the run can exacerbate brain fog, fuzziness and idiopathic dizziness. Worry about symptoms can also prolong recovery.

Seek support and learn tools inside the ROCK STEADY 12-week Program that you can use in your daily life to boost your steadiness and clarity.  There are plenty of tools to choose from in the Seeking Balance Online Programs.

Less Common Dizziness Conditions

Superior Canal Dehiscence (SCD)

Listen (3 minutes)

Key Points: Medical treatment available, dizziness triggered by loud noise or vibrations, brief vertigo, not positional, bodily sounds become more noticeable, hearing distortion.

What is it?

SCD is a thinning of the protective bony layer of the superior semicircular canal. This canal is a part of the balance system. As the fluid moves around the canal and responds to sound or movement vibrations, the thinning bone acts like a trampoline and bounces more than usual. In a normal ear we only have two moving trampoline like windows located near the middle ear.  These regulate the pressure waves moving through our inner ear fluid.  In SCD, people now have a third moving ‘window’ and this creates exaggerated sound and balance vibrations to pass through the inner ear system.  It results in sound sensitivity and vertigo with loud sounds.

The third moving ‘window’ causes vertigo (nystagmus eye movements) when exposed to sudden, sharp or loud sounds. This can also occur with large tapping vibrations placed anywhere on the body. This can be frightening for people with SCD who are unsure what is going on in their body at the time. It is experienced as a short flurry of visual/sound distortion and is different to light/sound sensitivity as seen in migraine.  This is a mechanical change within the inner ear and associated with clear triggers such as sneezing, blowing the nose, laughing, talking loudly etc.

With the thinning bone on the superior canal, there is more fluid movement and therefore increased balance signals passing through the vestibular organs. This can draw sound vibration away from the hearing organs and result in unusual sound distortions or tinnitus. Body functions (such as our heart beat or chewing sounds) can be heard as louder sound vibrations and become distressing or distracting for people with SCD.  Hearing body noises more loudly is common for people with SCD and is called ‘autophony’.

Treatment involves plugging up the affected canal surgically to stop the excessive fluid movement or blocking one of our moving ‘windows’ that sits closer to the middle ear. There are risks associated with surgery and it is not performed in all cases.  

Many people with SCD benefit from learning about managing the associated anxiety and emotional impact of these intermittent symptoms.  With time and understanding, symptoms can be minimised.

Listen here to in an interview about treating SCD surgically.

Learn more about holistic recovery using ROCK STEADY.  You can learn to better understand your symptoms and how to feel confident in your body again.

Mal Debarquement Disorder

Listen (3 minutes)

Key Points: Cause unknown, often triggered by an event of travel such as a boat trip, or may be triggered by stress. Symptoms often described as constant rocking or push/pull sensations, symptoms may be reduced when in motion such as swimming/ driving, medical investigation recommended to rule out other cause. 

What is it?

Mal Debarquement may be considered as a variant of vestibular migraine. There are suggestions that the rocking sensations occur due to confusion within the balance-brain. This part of our brain is important for prioritising information. In other words, it acts like a bouncer at the door of a nightclub who allows people entry under the condition that they are over 18, they are not intoxicated, and that the club is not already full. This job is important to maintain harmony within the nightclub.

Equally important is the job of the balance-brain. If the brain is confused and allowing all forms of stimuli (vibration, light, sound, emotion and touch etc.) entry into our experience, then it is no wonder that we might feel a constant swimming or rocking sensation.There is too much information to process and not enough selective order! Treatment takes a similar approach to vestibular migraine. Stress and anxiety reduction strategies will help the brain to optimise its efficiency. Being rushed, overworked, anxious or lacking sleep can exacerbate symptoms.

Get support tools from the ROCK STEADY 12-week Program to help re-set the balance brain and to feel like yourself again!

Acoustic Neuroma/Vestibular Schwannoma 

Listen (6 minutes)

Key points: Gradual onset of symptoms, usually in one ear only with symptoms such as tinnitus, fullness and sound distortions in that ear, intermittent dizziness and vertigo, medical investigation is required.

What is it?

An acoustic neuroma/vestibular schwannoma is a type of cancer that occurs along the eighth nerve (the balance and hearing nerve). Most commonly, it occurs along the vestibular nerve in the schwann cells. This nerve pathway takes information from the inner ears toward the brainstem.  Ordinarily, the schwann cells provide a protective insulation layer for the hearing and balance nerve. In the case of vestibular schwannoma, the schwann cells grow excessively and form a growth along this nerve. This can lead to hearing loss, vertigo and unusual sound distortions as the growth can compress the eighth nerve and reduce the efficacy of hearing and balance information passed along this pathway.

The cancer cells are usually benign. If the schwannoma is identified to be small in size, then the specialist may opt to monitor the growth annually rather than surgically remove it. This is called a conservative treatment approach. There is a chance that the schwannoma will remain small in size and not require medical intervention.

If surgery is indicated, the specialist will talk with you about the risks of surgery and the intended surgical approach. You may be at risk of further hearing loss and imbalance post-operatively but usually, patients understand that this is a worthwhile compromise. If left unmonitored a vestibular schwannoma could compress upon other cranial nerves and lead to serious health complications. Ear, Nose and Throat (ENT) surgeons will monitor the growth of the schwannoma over time with repeat MRI scans. As regrowth can occur following surgical removal, MRI scan monitoring each 1-5 years is generally recommended.

Following surgery, patients benefit from ROCK STEADY home exercises to help their balance system rebuild and strengthen new pathways. Emotional support tools will also useful throughout this treatment process.

BUT … Why Do I Have Persistent Dizziness?

Listen (5 minutes)

Persistent dizziness may linger for any condition if the ears/brain have a hard time recalibrating and re-learning balance control. If the balance brain is unable to recover itself, you may not feel ‘yourself’ for a little while. Using appropriate support tools and balance exercises, you will get there.

Let’s go through a list and see if any of these sound true for you:

  • Are you anxious about the dizziness and thinking about it a lot?
  • Are you overly cautious and protective of yourself in order to prevent dizziness?
  • Are worried about triggering dizziness?
  • Do you have BPPV that is untreated?
  • Do you have enough support to help you recover optimally?
  • Are you scared of the vertigo attacks or sick with worry about it?
  • Are you too busy and not resting enough for your body to bounce back?
  • Have you learnt tools and exercises to enable your body to recover?

Learn more support tools and become the expert in your recovery process with the Seeking Balance ROCK STEADY Program. Choose the support tools that best fit your needs. You can take control of your recovery and nobody else can do it for you. Start ROCK STEADY and feel like you again.

Read the article: ‘5 Common Misunderstandings About Vertigo’ here.