Dizziness/Vertigo/Imbalance

balance 2DDizziness/vertigo is among the most common reasons for presentation to a physician. It has many causes, and varies from mild to severe, transient to permanent. The most common causes are inner ear disturbances, migraine headache and Ménière disease. Those with ear disturbances (peripheral, outside the central nervous system/ CNS) often have tinnitus and hearing loss (vestibular neuronitis/labyrinthitis, benign paroxysmal positional vertigo/BPPV). Those with neurological causes (central/vestibular (brain stem), within the CNS) often suffer motion sickness. Serious CNS diseases (demyelination, tumors, or vascular lesions), illness (Lyme disease) and medication side effects must be excluded. Serious diseases causing dizziness are far less common than reversible ones.

While Western Medical diagnosis and treatment of dizziness/vertigo has advanced substantially over the past 15 years, a thorough symptom history and physical examination often provides the diagnosis. Auditory system and brain stem (vestibular/balance system) testing and imaging, occasionally with blood work, can determine whether or not the symptom belies a more serious underlying condition. New methods of vestibular testing (including ocular/spinal reflexes and evoked potentials) should be pursued for persistent symptoms, when available.

Today, there is an array of conventional treatments for sustained dizziness/vertigo. Medications include antivert/antihistamines, scopolamine/anti-cholinergic, anti-anxiety, and anti-nausea medications. Neurological (vestibular/balance) rehabilitation and occupational and physical therapy help prevent falls and improve safety. BPPV, benign paroxysmal positional vertigo, responds very well to “canalith repositioning:” a series of maneuvers done in a physical therapist’s office, then performed at home for recurrences. [1]

Traditional Chinese Medicine (TCM) has a long and effective history treating dizziness/vertigo. Independent of its Western etiology, TCM attributes dizziness/vertigo ultimately to “Liver Wind or Yang” rising to the head. This final common pathway (branch symptom) is itself attributable to a number of root causes. Treating both “root and branch” provides sustained relief. The majority of reversible causes of dizziness (BPPV, migraine-associated, vestibular neuronitis) respond quickly and lastingly to ear, Neurological Scalp and body acupuncture. Chinese Herbal Medicine helps not only “subdue the Liver Wind/Yang rising”, but addresses the root cause (“Kidney” Deficiencies, “Lung Overacting on Liver”, “Phlegm/Damp” accumulation, “Blood/Qi” deficiencies). Even those with more serious etiologies (MS/demyelination, post-stroke) should improve for days to weeks between treatments. Those with very serious causes (such as tumors) often only gain very temporary relief; if symptoms return within 24 hours after the second or third treatment, acupuncture should be abandoned. [2] [3] [4]

Neurological Conditions Testimonials

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These brief overviews of conditions represent distillations of basic and current medical reviews from the following sources:

[1] Conventional Medical Sources

“Harrison’s Principles of Internal Medicine: Volumes 1 and 2, 18th Edition”. Dan Longo Anthony Fauci, Dennis Kasper, Stephen Hauser, J. Jameson, Joseph Loscalzo. McGraw-Hill Professional; (July, 2011)

Medscape eMedicine Physician’s online resource. Various review articles:

Complex Regional Pain Syndromes Treatment & Management.
Anthony H Wheeler MD. Medscape Reference Chief Editor: Stephen A Beman, MD PhD MBA.

Essential Tremor
Deborah A Burke, MD Clinician, Sub-Investigator, Movement Disorder/Parkinson’s Disease Center, University of South Florida College of Medicine; Investigator, Physician, Roskamp Institute Memory Clinic

Bell Palsy
Danette C Taylor, DO, MS Clinical Assistant Professor, Department of Neurology and Ophthalmology, Michigan State University College of Osteopathic Medicine; Senior Staff Neurologist, Henry Ford Health Systems

Meniere Disease (Idiopathic Endolymphatic Hydrops)
John C Li, MD Private Practice in Otology and Neurology; Medical Director, Balance Center

Restless Legs Syndrome
Ali M Bozorg, MD  Assistant Professor, Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida College of Medicine

Postherpetic Neuralgia
W Alvin McElveen, MD  Director, Stroke Unit, Lakewood Ranch Medical Center; Neurologist, Manatee Memorial Hospital

Sleep disorders
Roy H Lubit, MD, PhD  Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice

Tinnitus
Aaron G Benson, MD  Director, Ohio Hearing and Balance Institute, Maumee, Ohio; Consulting Staff, Toledo Ear, Nose and Throat, Inc

Multiple Sclerosis
Christopher Luzzio, MD  Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison School of Medicine and Public Health

Parkinson Disease
Robert A Hauser, MD, MBA  Professor of Neurology, Molecular Pharmacology and Physiology, Director, USF Parkinson’s Disease and Movement Disorders Center, National Parkinson Foundation Center of Excellence, Byrd Institute, Clinical Chair, Signature Interdisciplinary Program in Neuroscience, University of South Florida College of Medicine

Tourette Syndrome and Tic Disorders
William C Robertson Jr, MD  Professor, Departments of Neurology, Pediatrics, and Family Practice, Clinical Title Series, University of Kentucky College of Medicine

Post Concussive Syndrome
Roy H Lubit, MD, PhD  Assistant Clinical Professor, Mount Sinai School of Medicine; Clinical Faculty, Department of Child Psychiatry, New York University School of Medicine; Private Practice

Traumatic Brain Injury
Segun T Dawodu, MD, JD, MBA, LLM, FAAPMR, FAANEM  Associate Professor of Rehabilitation Medicine and Interventional Pain Medicine, Albany Medical College

Dizziness, Vertigo, Imbalance
Hesham M Samy, MD, PhD  Head of Hearing and Balance Unit, Otolaryngology Department, Minia University, Egypt

CNS Causes of Vertigo
Marcelo B Antunes, MD  Resident Physician, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System

Communication Disorders
Renee S Melfi, MD  Consulting Staff, Orthopaedic Associates of Central New York

[2], [3]

  • “Acupuncture Energetics: A Clinical Approach for Physicians”. Joseph M. Helms. Medical Acupuncture Publishers; 1st Edition. (1995)
  • “Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists”. Giovanni Maciocia. Churchill Livingstone; 2 Edition (July, 2005).
  • “Diagnosis in Chinese Medicine: A Comprehensive Guide”. Giovanni Maciocia. Churchill Livingstone; 1st Edition (January, 2004).

Chinese Scalp Acupuncture”. Jason Ji-shun Hao, Linda Ling-zhi Hao and Honora Lee Wolfe. Blue Poppy Press; 1st Edition. (November, 2011)