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Dizziness and balance disorders can have many different causes. The most common causes are benign positional vertigo (benign paroxysmal positional vertigo, BPLS), migraine-associated vertigo (vesibular migraine), a disorder of the vestibular organ/nerve (peripheral vestibular dysfunction)migraine-associated vertigo (vesibular migraine), a disorder of the vestibular organ/nerve (peripheral vestibular dysfunction), a disorder of the vestibular and auditory organs (Menière's disease).

Dizziness and balance disorders can also be caused by an age-related decline in the function of the vestibular organ (presbyvestibulopathy). Cardiovascular diseases (arrhythmia, high or low blood pressure), misalignment of the eyes (strabismus, uncorrected defective vision) or anxiety and depression can also lead to dizziness. The latter can also lead to dizziness or unsteadiness persisting for longer after another illness.

Other rare illnesses can also lead to dizziness and balance disorders, such as

  • inflammatory diseases of the brain (multiple sclerosis)
  • Tumors of the vestibular nerve (vestibular schwannoma)
  • Sensory disorders in the extremities (e.g. polyneuropathy)
  • General muscle weakness, muscle stiffness, poor posture and joint problems

In order to make or rule out the correct diagnosis, various further specialist examinations are necessary, depending on the situation.

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Further diagnostic examinations

The ears, nose and nasopharynx, mouth, pharynx as well as the larynx and throat including the neck muscles are examined. To examine vertigo, the eyes are examined to see involuntary eye movements (nystagmus). Various standing and walking tests are carried out to examine balance, as well as various positioning maneuvers while lying down, with simultaneous examination of the eyes.

Further, frequent instrumental examinations

Hearing tests are carried out to examine the function of the auditory organ, which is very close to the vestibular organ. Depending on the situation, different types of hearing tests are carried out, in which either sounds, speech or the mobility of the eardrum are examined.

The video head impulse test examines the vestibular system. You constantly fixate on a point with video goggles while your head is simultaneously turned with very fine movements so that a reflex between the eyes and the vestibular organ is triggered and then measured and evaluated.

Videoculography is a detailed examination of the vestibular system. You sit on a chair with video goggles and fixate various points with your eyes or look at passing stripes. A brief rotation of the chair stimulates the vestibular system and, in response, eye movements take place which we can measure. Briefly rinsing the auditory canal with water also stimulates the vestibular system so that we can then see and measure eye movements.

As part of the balance analysis, trunk movements are analysed to stabilize balance during various walking and standing tests. For this purpose, a small device with a belt is worn on the back while various walking and standing exercises are performed.

Vemps are used to examine special parts of the vestibular system that register gravity (utriculus and sacculus), among other things. A few electrodes are attached to the outside of the neck or forehead and cheek and the utriculus or sacculus are stimulated by sounds or tapping on the forehead. Their response is recorded and evaluated.

Detailed blood pressure measurements, both lying and standing or over 24 hours, are possible, as well as an ultrasound examination of the heart, a long-term or stress ECG, depending on the situation.

Symptoms of dizziness often occur in conjunction with headaches. An acute loss of balance can also be caused by a stroke. Furthermore, many dizziness syndromes and balance disorders are caused by combinations of impairments of several sensory systems. Dizziness and balance disorders can also be the first signs of diseases such as Parkinson's disease, multiple sclerosis or dementia, and these symptoms and disorders often occur during the course of these diseases. The Department of Neurology carries out targeted diagnostics and appropriate treatment according to the latest findings.

The eyes, in particular the position of the eyes, the voluntary and involuntary movement of the eyes and the coordination of their cooperation are examined, as are the eyesight (visual acuity, objective refractive power, visual field) and the ability to focus.

Dizziness and insecurity often lead to anxiety and a reduction in quality of life. This can result in an anxiety disorder or change the mood to the point of depression; both can in turn be accompanied by insecurity and dizziness. As part of the psychosomatic examination, the effects of the symptoms are recorded and coping strategies are developed together.

Examinations using computer tomography, magnetic resonance imaging or additional special radiological examinations can be carried out depending on the individual case.

The spine, its function and any impairments are examined in detail.

Weekly interdisciplinary sensory board

An interdisciplinary sensory board takes place once a week, in which specialists from various disciplines at the center participate and discuss patients whose clinical pictures are not clear or who suffer from various diseases. If you wish, your referring general practitioner can also take part in this meeting. You will then be informed of the treatment recommendation.

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An interdisciplinary sensory board takes place once a week, in which specialists from various disciplines at the center participate and discuss patients whose clinical pictures are not clear or who suffer from various diseases. If you wish, your referring general practitioner can also take part in this meeting. You will then be informed of the treatment recommendation.