Dizziness begins in ear

Dear Dr. Donohue: Will you write about dizziness? What causes it? What can be done for it? — M.H.

Answer: Dizziness — vertigo — is a sensation that you or the world around you is whirling like a merry-go-round. It’s not lightheadedness, which is the sensation of being on the verge of fainting.

The ear is more than the organ of hearing; it’s also the balance organ, sending information to the brain, telling it where we are in space and making us feel firm-footed. With impairment of the body’s balance organ, dizziness results. Dizziness also can come from a misfiring of the nerve that transmits balance sensations to the brain or to the part of the brain that reads the balance input. However, most of the time, it’s an ear problem.

Vestibular neuritis is a viral infection of the hearing nerve that causes dizziness. It comes on suddenly and produces such vertigo that a person has to stay in bed for a day or two. Severe dizziness leaves in a week or more, but residual effects can last for months. Phenergan, Antivert and the scopolamine patch can reduce this sort of dizziness.

Meniere’s disease consists of recurring episodes of dizziness, hearing loss and ear ringing. Between episodes, things return to normal. With the passage of time, however, intervals between spells become briefer and symptoms last longer. Treatment for this condition is more complicated.

Benign positional vertigo is a common cause of dizziness. When a person turns over in bed, turns the head or looks up to search for something on a top shelf, vertigo strikes. Sometimes people can treat this kind of dizziness with a series of the following maneuvers. The affected person sits on a bed and turns the head to the right. That position is held for half a minute and returned to the original position.

Then the body is lowered to the bed so the head projects over a pillow at neck level. The head is turned to the right again and held there for 30 seconds. Then it’s turned to the left for 30 seconds. At that point, the person rolls onto the left side for another 30 seconds. This drill is repeated two more times, and the series of exercises is done three times a day. If the movements make dizziness worse, stop.

Self-treatment might not get you anywhere. If that’s the case, an ear, nose and throat doctor should be asked to step in.

Dear Dr. Donohue: I have pain in one knee. What kind of doctor should I see? — M.M.

Answer: A family doctor. He or she can examine the knee and usually come up with a diagnosis and treatment. If the doctor cannot, then he or she will refer you to the appropriate specialist — a rheumatologist or an orthopedic surgeon.