Dizziness and Balance
The first thing to figure out is what patients mean by dizzy. If there is a sense that you are moving or the world is moving that is actually vertigo. The cause of vetigo is usually a problem in the inner ear or the way the brain is communicating to the inner ear. This set of conditions is called vestibulopathy, and can be assessed using different kinds of vestibular testing (VAT), and can many times be helped by vestibular physical therapy. If patients feel light headed like they are going to pass out, or are having problems with passing out, this means the brain is not getting enough blood pressure or oxygen and can be a problem with the heart itself, blood pressure, cardiac rhythm issues, or the way the autonomic nervous system is controlling all those things together. Frequently medication interaction can cause patients to feel light headed or dizzy and can be addressed.
Balance issues can be related to a number of neurologic issues from the brain such as stroke, or Parkinsons, to the spinal cord, to the nerves in the legs, such as is seen in peripheral neuropathy from conditions like diabetes or vitamin deficiencies. Brain issues can be assessed with imaging studies and spine and nerve problems can be assessed using nerve conduction studies (EMG/NCON).