Vertigo and Balance Disorders

Vertigo, dizziness and balance problems can happen for many reasons. If you have sudden vertigo or dizziness, especially with a headache, call your doctor right away. Sudden vertigo could be a sign of stroke.

You might have vertigo or loss of balance because of a disturbance in your vestibular system (part of the inner ear responsible for balance) due to:

• Age-related changes.
• Ear conditions like tinnitus or Ménière’s disease.
• Headache or migraine.
• Medications you’re taking.
• Motion sickness.
• Neurologic conditions like Alzheimer’s disease or Parkinson’s disease.

Vertigo can also happen if you get up too quickly, causing a sudden change in your blood pressure. If you change positions too fast, you might experience benign paroxysmal positional vertigo (BPPV).

Diagnosing Vertigo and Balance Disorders at Cleveland Clinic

Our experts diagnose vertigo and balance disorders with a full evaluation. You may choose between doing all evaluation appointments and testing in a single day at our main campus. We call this type of appointment a "Dizzy Clinic.”

You may decide you prefer a more traditional appointment at a location closer to home. If you do, you’ll meet with one of our experienced head and neck specialists. They will order testing for another date following your evaluation.

For either type of visit, we may ask you to complete an online questionnaire before coming to our clinic for your appointment.

During your appointment, our specialists will:

• Take a detailed medical history.
• Review your online questionnaire.
• Examine your vestibular system, which may include a vestibular test battery.
• Check your balance and how you move and walk.

Our vestibular specialists (audiologists and physical therapists) work with healthcare providers to rule out growths, tumors or other system-related causes of vertigo and balance disorders. We recommend you to other specialists for evaluation if needed and talk with your primary care provider about what we learn.

Testing for Children

Children of all ages can also experience vertigo, dizziness, imbalance and unsteadiness due to inner ear (vestibular) dysfunction. These symptoms can impact their overall quality of life and sometimes pose safety risks.

Younger children often cannot explain their symptoms, making vestibular dysfunction hard to recognize. Our experts will work with your child’s pediatrician to better understand what’s causing your child’s symptoms by doing specialized testing.

Having your child tested may be necessary if you notice any or a combination of the following signs:

• General imbalance.
• Frequent falls.
• Delayed motor milestones.
• Clumsiness.
• Head tilt.
• Rhythmic eye movement (nystagmus).
• Nausea when riding in a car.

Our experts develop management plans that relieve dizziness and help you stand strong. We may recommend:

Medication management for vertigo and balance disorders

Some medications or taking too many drugs at the same time (polypharmacy) can cause vertigo and balance problems. Our experts safely wean you off medicines that may be contributing to balance issues.

Vestibular therapy for vertigo and balance disorders

Our physical therapists use specific exercises to improve your balance and reduce dizziness. We design a personalized vestibular rehabilitation program to address your unique needs.

Psychological therapy for vertigo and balance disorders

Vertigo and balance problems can make daily activities challenging and create stress. Our experts may recommend that you meet with a psychologist to learn techniques and strategies to manage these feelings, such as:

• Breathing exercises: We teach you how to use your breath to reduce stress and anxiety.
• Cognitive behavioral therapy: We help you change how you think about dizziness and balance problems. During cognitive behavioral therapy, we give you problem-solving skills you can use to feel more confident and in control.
• Grounding: We teach you to orient yourself to your physical space and how to distract yourself from dizziness.

Surgery for vertigo and balance disorders

Sometimes, medication changes and other therapies may not help. Cleveland Clinic surgeons in neurology and otolaryngology help relieve causes of vertigo and balance disorders with specialized surgical procedures, such as:

• Microvascular decompression: We relieve pressure in blood vessels affecting the ear’s nerves.
• Removal of growths or tumors: We remove benign growths on the nerves (acoustic neuroma) and structures of the ear (cholesteatoma).

Falls Prevention Therapy at Cleveland Clinic

Vertigo and dizziness can increase your risk of falling. Our falls prevention therapy specialists develop personalized exercise programs to help you move safely and confidently.

Taking the Next Step

Balance isn’t something many people think about. But when you experience dizziness, vertigo or balance disorders that make your world tilt, it can cause anxiety and stress. Our experts can help set your world right again and let you enjoy each day with confidence.