Balance & Dizziness Click here for Services

( Obtained from the American Hearing Research Foundation)

What is dizziness?

Dizziness may be a fleeting sensation or the prolonged and intense symptom of a wide range of health problems that can affect a person's independence, ability to work, and quality of life. Experts believe that more than 40 percent of Americans will experience dizziness that is serious enough to go to a doctor. Even dizziness that seems minor, if undiagnosed, may be a signal of u nderlying disorders.

Balance problems are among the most common reasons that older adults seek help from a doctor. Many people are surprised to learn that the source of their imbalance may be in their inner ears. Balance (or vestibular) problems are reported in about 9 percent of the population who are 65 years of age or older. Fall-related injuries such as breaking (or fracturing) a hip are a leading cause of death and disability in older individuals. Many of these hip fractures are related to balance disorders. Although this fact sheet is about adults, children who complain about or describe balance problems should be seen by a doctor.

Balance disorders may also lead to other problems including fatigue, difficulty walking, or disinterest in everyday and leisure activities. If you or your child, parent, friend, or co-worker has a balance problem--take it seriously. Talk to the doctor about what happens when you feel dizzy or lose your balance. Be as careful as possible to describe your experience of dizziness specifically.

( Information Taken from The NATIONAL INSTITUTE OF DEAFNESS AND OTHER COMMUNICATION DISORDERS website (NIDCD)

What Are the Symptoms of a Balance Disorder?

When balance is impaired, an individual has difficulty maintaining orientation. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. Some of the symptoms a person with a balance disorder may experience are:

• A sensation of dizziness or vertigo (spinning).
• Falling or a feeling of falling.
• Lightheadedness or feeling woozy.
• Visual blurring.
• Disorientation.

Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the 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?

Infections (viral or bacterial), head injury, disorders of blood circulation affecting the inner ear or brain, certain medications, and aging may change our balance system and result in a balance problem. Individuals who have illnesses, brain disorders, or injuries of the visual or skeletal systems, such as eye muscle imbalance and arthritis, may also experience balance difficulties. A conflict of signals to the brain about the sensation of movement can cause motion sickness (for instance, when an individual tries to read while riding in a car). Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort. 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 .

How Are Balance Disorders Diagnosed?

Diagnosis of a balance disorder is complicated because there are many kinds of balance disorders and because other medical conditions--including ear infections , blood pressure changes, and some vision problems--and some medications may contribute to a balance disorder. A person experiencing dizziness should see a physician for an evaluation.

Your physician will usually obtain a detailed medical history and perform a physical examination to start to sort out possible causes of the balance disorder. The physician may require tests to assess the cause and extent of the disruption of balance. The kinds of tests needed will vary based on the patient's symptoms and health status. Because there are so many variables, not all patients will require every test.

Some examples of diagnostic tests include a hearing examination, blood tests, an electronystagmogram (ENG--a test of the vestibular system), or imaging studies of the head and brain.

The caloric test may be performed as part of the ENG. In this test, each ear is flushed with warm and then cool water, usually one ear at a time; the amount of nystagmus resulting is measured. Weak nystagmus or the absence of nystagmus may indicate an inner ear disorder.

Another test of the vestibular system, posturography, requires the individual to stand on a special platform capable of movement within a controlled visual environment; body sway is recorded in response to movement of the platform and/or the visual environment.

How Are Balance Disorders Treated?

There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, such as ear infection, stroke, or multiple sclerosis. Individual treatment will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests.

Another treatment option includes balance retraining exercises (vestibular rehabilitation). The exercises include movements of the head and body specifically developed for the patient. This form of therapy is thought to promote compensation for the disorder. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body.

For people diagnosed with Ménière's disease, dietary changes such as reducing intake of sodium may help. For some people, reducing alcohol, caffeine, and/or avoiding nicotine may be helpful. Some aminoglycoside antibiotics, such as gentamicin and streptomycin, are used to treat Ménière's disease. Systemic streptomycin (given by injection) and topical gentamicin (given directly to the inner ear) are useful for their ability to affect the hair cells of the balance system. Gentamicin also can affect the hair cells of the cochlea, though, and cause hearing loss. In cases that do not respond to medical management, surgery may be indicated.

A program of talk therapy and/or physical rehabilitation may be recommended for people with anxiety.