Vertigo & Dizziness in Reno, NV
Dizziness and vertigo are among the most disabling symptoms a person can experience — turning everyday activities into a constant struggle. At Gates Brain Health, Dr. Randall Gates, D.C., Board Certified Chiropractic Neurologist, specializes in identifying why your brain isn’t adapting to vestibular dysfunction — and creating a personalized plan to help it recover.
Request an AppointmentThe Scope of Dizziness and Vertigo
Dizziness and vertigo are incredibly common — estimates suggest that between 15–35% of the population experiences dizziness at any given time, and the prevalence increases significantly with age. Yet despite how common they are, chronic dizziness and vertigo are notoriously difficult to fully resolve through the standard medical pathway.
The word “dizzy” means different things to different people. At Gates Brain Health, we carefully distinguish between these presentations:
- Vertigo — a false sensation of spinning or movement, either of yourself or your surroundings
- Lightheadedness or presyncope — a feeling of nearly blacking out, often position-related (see also POTS)
- Disequilibrium — unsteadiness or imbalance without a spinning sensation
- Oscillopsia — the visual sensation that the environment is moving or bouncing
- Mal de Débarquement — a persistent rocking or swaying sensation, often following travel
The Standard Pathway — And Why It Often Falls Short
The typical journey for a dizziness or vertigo patient goes like this: primary care physician → ear, nose and throat (ENT) specialist or neurologist → MRI or CT scan → balance and eye movement testing → hearing evaluation → diagnosis (often Meniere’s disease, vestibular neuronitis, vestibular hypofunction, BPPV, or vestibular migraines) → prescription for anti-nausea medication, vestibular suppressants, and physical therapy.
This pathway helps many patients — but a significant portion continue experiencing symptoms even after completing this standard workup and treatment. If that sounds like you, you are not alone.
The Critical Question: Why Isn’t Your Brain Adapting?
The prevailing model of vestibular disorders focuses on the inner ear as the source of the problem. And while the inner ear is often where dysfunction begins, chronic dizziness and vertigo are frequently maintained by the brain’s failure to compensate for whatever happened to the inner ear.
Human research has demonstrated that the vestibular nerve can be completely severed — eliminating all inner ear input on one side — and the brain should functionally compensate within approximately 7 days. So if someone is still experiencing significant dizziness weeks, months, or years after a vestibular event, the problem is not in the ear. The problem is that the brain is not adapting. That is the question Gates Brain Health is specifically equipped to answer.
Common Vestibular Conditions We Treat
- Benign Paroxysmal Positional Vertigo (BPPV)
- Vestibular Neuronitis / Neuritis
- Vestibular Migraines
- Meniere’s Disease
- Mal de Débarquement Syndrome
- Persistent Postural-Perceptual Dizziness (PPPD)
- Vestibular Hypofunction
- POTS-related dizziness
Our Approach to Vestibular Evaluation and Treatment
At Gates Brain Health, our vestibular evaluation goes far beyond what most clinics offer. Dr. Gates uses videonystagmography (VNG) — computerized eye movement testing — to evaluate both the inner ear (via caloric testing) and how the brain is processing vestibular signals. Because eye movements are controlled by the brainstem and cerebellum, VNG provides a precise window into central vestibular processing that standard physical examination cannot match.
In addition to VNG, Dr. Gates conducts a full neurological examination, evaluates posture, balance, and coordination, reviews any available imaging, and performs comprehensive laboratory testing to identify contributing factors such as autoimmune conditions, thyroid dysfunction, nutritional deficiencies, and inflammatory markers.
Treatment is highly individualized and may include vestibular rehabilitation exercises, neuroplasticity-based therapies to retrain brain compensation, dietary interventions, targeted supplementation, and treatment of any identified underlying conditions driving the vestibular dysfunction.
Mal de Débarquement Syndrome
Vestibular Migraines
Persistent Postural-Perceptual Dizziness
If dizziness or vertigo is limiting your life, call Gates Brain Health at (775) 507-2000 or schedule a consultation in Reno, NV today.
Frequently Asked Questions About Vertigo & Dizziness
What is the difference between vertigo and dizziness?
Dizziness is a broad term encompassing many different sensations — lightheadedness, unsteadiness, or feeling faint. Vertigo is a specific type of dizziness characterized by a false sensation of spinning or movement — either you feel like you’re spinning or your surroundings are. True vertigo typically originates from vestibular (inner ear or brain) dysfunction and requires a specialized evaluation to properly diagnose and treat.
What causes chronic dizziness?
Chronic dizziness is most commonly caused by the brain’s failure to fully compensate for an inner ear disorder. Even after the original inner ear problem has resolved or stabilized, the brain may remain stuck in a dyscompensated state — continuing to generate dizziness despite the absence of active inner ear damage. Central factors including brainstem dysfunction, cerebellar dysfunction, anxiety, autoimmune conditions, and thyroid dysfunction can all impair vestibular compensation.
What is VNG testing and why is it important?
Videonystagmography (VNG) is computerized testing that uses infrared cameras to precisely record and analyze eye movements. Because the vestibular system and eye movement system are tightly linked, VNG provides detailed information about both inner ear function (through caloric testing) and central vestibular processing in the brainstem and cerebellum. It is far more informative than simple bedside examination and is a cornerstone of Dr. Gates’ vestibular evaluation.
Can autoimmune conditions cause vertigo?
Yes. Autoimmune inner ear disease is a recognized cause of fluctuating sensorineural hearing loss, tinnitus, and vestibular dysfunction that can mimic Meniere’s disease. Additionally, conditions like Hashimoto’s thyroiditis, celiac disease, and lupus can contribute to vestibular instability through neuroinflammation and impaired cerebral blood flow. Dr. Gates evaluates for autoimmune contributions in every complex dizziness case.
What is Persistent Postural-Perceptual Dizziness (PPPD)?
PPPD is a central vestibular disorder characterized by persistent non-spinning dizziness, unsteadiness, and heightened sensitivity to movement and visual stimulation. It typically develops after an acute vestibular event and is maintained by central nervous system hypersensitivity. Treatment focuses on desensitization through vestibular and cognitive-behavioral rehabilitation, neuroplasticity-based approaches, and addressing any underlying triggers.
Does Gates Brain Health treat Meniere’s disease?
Yes. Meniere’s disease is one of the vestibular conditions Dr. Gates specializes in. His approach addresses the dietary, autoimmune, and neurological components of Meniere’s — going beyond simple symptom management to identify and reduce the triggers that drive episodes. Learn more on our Meniere’s disease page.
How do I get started at Gates Brain Health for vertigo or dizziness?
Call Gates Brain Health at (775) 507-2000 or schedule a free consultation online. Dr. Gates will review your history and symptom pattern, and explain what his comprehensive vestibular evaluation would involve and how it differs from what you may have already received. Both local and distance patients are welcome.