Dizziness is a broad term for feeling lightheaded, unsteady, or off-balance. Vertigo is a specific type of dizziness — the false sensation that you or the room around you is spinning or moving. Vertigo is almost always caused by a problem in the inner ear or the brain pathways that process balance. Disequilibrium is a persistent sense of unsteadiness without spinning, common in older adults and significantly increasing fall risk.
The most common cause of vertigo. Tiny calcium crystals become dislodged in the inner ear, causing brief intense spinning episodes triggered by head movements — rolling over in bed, looking up, or bending down. BPPV is highly treatable with repositioning maneuvers performed in the office, often in a single visit.
Viral inflammation of the vestibular nerve (neuritis) or entire inner ear (labyrinthitis) causes sudden, severe vertigo lasting days, often with nausea and vomiting. Hearing loss may accompany labyrinthitis.
A chronic inner ear disorder causing episodes of intense vertigo lasting 20 minutes to several hours, with fluctuating low-frequency hearing loss, tinnitus, and ear fullness. Manageable with dietary changes, medications, and audiology care.
A benign, slow-growing tumor on the vestibular nerve producing gradual one-sided hearing loss, tinnitus, and balance disturbances. Early detection is important — Dr. Nelson will refer for MRI if suspected.
As the vestibular system, vision, and proprioception decline with age, unsteadiness and fall risk increase. This is not inevitable with the right intervention.
Dozens of common medications — blood pressure drugs, antidepressants, certain antibiotics — list dizziness as a side effect. Dr. Nelson’s evaluation includes a careful medication review.
A proper vestibular evaluation is thorough and systematic. Dr. Nelson’s assessment includes:
The most immediately effective treatment in all of audiology. For BPPV, the Epley repositioning maneuver guides displaced crystals back into position. Success rates exceed 80% in a single in-office session — most patients feel dramatically better before they leave.
A specialized form of physical therapy that retrains the brain’s balance processing — proven to reduce dizziness, improve gaze stability, and decrease fall risk. Dr. Nelson coordinates VRT referrals with experienced NYC physical therapists.
A low-sodium diet, reduced caffeine and alcohol, and stress management are foundational to Meniere’s management. Dr. Nelson provides specific dietary guidance and works closely with your physician.
When vestibular disorders require medical intervention — diuretics, intratympanic steroid injections, or surgical evaluation — Dr. Nelson coordinates promptly with appropriate NYC specialists.
For older adults or anyone at elevated fall risk, Dr. Nelson provides a structured fall risk evaluation and connects patients with home safety resources and balance training programs.
What is the fastest treatment for vertigo?
For BPPV, the Epley maneuver can provide dramatic relief in a single office visit — often within minutes. Most patients leave feeling significantly better.
Can vertigo go away on its own?
BPPV sometimes resolves spontaneously but often recurs. Vestibular neuritis improves over weeks to months; VRT accelerates recovery. Meniere’s disease requires ongoing management.
Is it safe to drive with vertigo?
No. Active vertigo is a serious driving hazard. Please arrange alternative transportation until your condition has been evaluated and stabilized.
Do I need a referral?
No referral is needed. Call (646) 436-7590 directly. Same-week appointments typically available.
Can you do an in-home vestibular evaluation?
Yes. Pinnacle Audiology offers in-home assessments throughout Manhattan and all five boroughs — especially useful for patients with active vertigo who cannot safely travel.
Call Pinnacle Audiology at (646) 436-7590 or visit us at 421 7th Ave, Suite 707, New York, NY 10001. Same-week appointments available. In-home visits available throughout NYC.
