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What is a balance disorder?
A balance disorder can cause you to feel unsteady, giddy, woozy, or to have a sensation of movement, spinning, or floating. The source for this disorder can be linked to the brain, the nervous system and to an organ in the inner ear called the labyrinth. An important part of our vestibular (balance) system, the labyrinth interacts with other systems in the body, such as the visual system (eyes) and skeletal system (bones and joints) system, to maintain the body’s position.

What are the parts of the ear that affect balance?
Within the labyrinth are three fluid-filled structures known as the superior, posterior and horizontal semicircular canals. Moving fluid within these canals let you know when you are in a rotary (circular) motion. The semicircular canals and the visual and skeletal systems have specific functions that determine your orientation. The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ).

The vestibular system works with the visual system to keep objects in focus when the head is moving. Joint and muscle receptors also are important in maintaining balance. The brain receives, interprets, and processes the information from these systems that control your balance.

Diagram of the ear

What are the symptoms of a balance disorder?
If your balance is impaired, you may have difficulty maintaining orientation. For example, you may experience the “room spinning” or not being able to walk without staggering. You may not even be able to arise. Additional symptoms include:

  • A sensation of dizziness or vertigo (spinning)
  • Falling or a feeling of falling
  • Lightheadedness or feeling woozy
  • Visual blurring
  • Disorientation
  • Nausea and vomiting, diarrhea
  • Faintness
  • Changes in heart rate
  • Fear, anxiety or panic.

Some reactions to these symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period of time.

What causes a balance disorder?
Balance disorders can be due to problems in any of four areas:

  • Peripheral vestibular disorder, a disturbance in the labyrinth
  • Central vestibular disorder, a problem in the brain or its connecting nerves
  • Systemic disorder, a problem of the body other than the head and brain
  • Vascular disorder, or blood flow problems.

Balance disorders may be triggered by a variety of things. Infections (viral or bacterial), head injury, disorders of blood circulation affecting the inner ear or brain, certain medications, and aging may change your balance system and result in a balance problem. If you suffer from a brain disorder or an injury of the visual or skeletal systems, such as eye muscle imbalance and arthritis, you may also experience balance difficulties.

A conflict of signals to the brain about the sensation of movement can cause motion sickness, which is a type of balance disorder. A common trigger is reading in a moving vehicle. Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort

What are some types of balance disorders?
Some of the more common balance disorders are:

  • Benign Paroxysmal Positional Vertigo (BPPV): A brief, intense sensation of vertigo that occurs because of a specific positional change of the head. You may experience BPPV when rolling over to the left or right upon getting out of bed in the morning, or when looking up for an object on a high shelf. The cause of BPPV is not known, although it may be caused by an inner ear infection, head injury, or aging.
  • Labyrinthitis: An infection or inflammation of the inner ear causing dizziness and loss of balance.
  • Meniere’s Disease: An inner ear fluid balance disorder that causes episodes of vertigo, fluctuating hearing loss, tinnitus (a ringing or roaring in the ears), and the sensation of fullness in the ear. The cause of Meniere’s disease is unknown.
  • Vestibular Neuronitis: An infection of the vestibular nerve, generally viral.
  • Perilymph Fistula: A leakage of inner ear fluid to the middle ear. It can occur after head injury, physical exertion or, rarely, without a known cause.

How are balance disorders diagnosed?
Diagnosis of a balance disorder is complicated. There are several types of disorders as well as medical conditions and medications themselves that may contribute to the condition. For these reasons, if you experience dizziness, see a physician for an evaluation.

Your physician may recommend that you see a an otolaryngologist, a doctor that specializes in diseases disorders of the ear, nose, throat, head, and neck. Testing at the office may include a hearing examination, blood tests, an electronystagmogram (ENG), a test of the vestibular system, or imaging studies of the head and brain.

A caloric test may be performed as part of the ENG (electronystagmography) to check for an inner ear infection.

Another test called posturography requires you to stand on a special platform capable of movement within a controlled visual environment. Your body sway is recorded in response to movement of the platform and/or the visual environment.

How are balance disorders treated?
Individual treatment for a balance disorder will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests.

How can I help my doctor make a diagnosis?
You can take the following steps that may be helpful to your physician in determining a diagnosis and treatment plan.

  • Bring a written list of symptoms and your current list of medications to your doctor.
  • Be specific when you describe the nature of your symptoms to your doctor. For example, describe how, when, and where you experience dizziness.
  • Write down any instructions or tips your doctor gives you.

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