Balance Awareness

by Ms Joanna C Stephens, Consultant Ear, Nose & Throat Surgeon

Balance problems are very common and affect many people at some point in their lives.

Whilst a balance problem is happening it can be very distressing and worrying for the patient, but many of these conditions are treatable and will subside in time.

If the patient is still symptomatic after a few weeks with supportive measures, or after several episodes of sporadic vertigo, it would be reasonable to refer to an ENT Consultant who can fully assess the patient and make a treatment plan.

ENT appointment

An ENT doctor will take a detailed history of exactly when symptoms began and what they are, and when the symptoms occur.  The patient will be asked about any dizzy spells, which can be due to vertigo i.e. a spinning/rotational sensation, or due to a feeling of light-headedness or unsteadiness.

An ENT doctor will also perform or arrange a hearing test and carry out a detailed neurological examination.


Often the process described above is all an ENT doctor needs to make a diagnosis and provide a treatment plan.

Patients may need more detailed balance tests, but this is unusual.

Patients may need to have an MRI scan (or an alternative scan if they cannot undergo an MRI scan)


Of course the treatment depends on the diagnosis, and there are many different issues which can cause balance problems.

An ENT doctor might perform the Epley manoeuvre. This is a re-positioning manoeuvre which is done during the appointment to treat a problem of BPPV (Benign Positional Paroxysmal Vertigo).

Betahistine tablets to treat Meniere’s Syndrome, or blood pressure tablets, may be prescribed.

Some of the conditions which may be diagnosed:


Labyrinthitis is a feeling of often very intense vertigo (or spinning sensation) which comes on quite suddenly and can last for a few days or up to a few weeks. It will usually settle down in time, and needs treatment only to help with the nausea or vomiting caused by the dizziness.


Benign positional paroxysmal vertigo (BPPV) is a common problem caused by tiny particles in the inner ear balance system moving into the wrong area temporarily. This causes intermittent episodes of dizziness or vertigo which often occur on turning the head, for example whilst rolling over in bed. This can be treated in the outpatients clinic with the Epley Manouvre, which is a simple procedure designed  to encourage the particles back into the correct position.

Meniere’s Disease

Meniere’s is an uncommon problem, where patients suffer with episodes of dizziness or vertigo, which can occur at the same time as tinnitus or changes in the hearing. Over time the hearing can be affected. There are lots of different treatment options available and these include blood pressure tablets, Betahistine tablets, or steroid treatments.

Ms Joanna Stephens is available at One Hatfield Hospital either by booking directly through our Reservations Team on 01707 44 33 33 or by GP referral

Miss Joanna Stephens

One Hatfield is unique providing diagnostic care and same or next day appointments, and is ideally located for patients in Hatfield, St Albans, Stevenage, Watford, North London and throughout Hertfordshire and Bedfordshire.