Dr. Sidhharth Yande

ENT Surgeon Pune

Balance Disorders

Overview

Balance problems can make you feel dizzy, as if the room is spinning, unsteady, or lightheaded. You might feel that you’re going to fall down. These feelings can happen whether you’re lying down, sitting or standing.

Many body systems — including your muscles, bones, joints, vision, the balance organ in the inner ear, nerves, heart and blood vessels — must work normally for you to have normal balance. When these systems aren’t functioning well, you can experience balance problems.

Many medical conditions can cause balance problems. However, most balance problems result from issues in your balance end-organ in the inner ear (vestibular system).

Causes

Balance problems can be caused by several different conditions. The cause of balance problems is usually related to the specific sign or symptom.

Vertigo can be associated with many conditions, including:

  1. Benign paroxysmal positional vertigo (BPPV). BPPV occurs when calcium crystals in your inner ear — which help control your balance — are dislodged from their normal positions and move elsewhere in the inner ear. BPPV is the most common cause of vertigo in adults. You might experience a spinning sensation when turning in bed or tilting your head back to look up.
  2. Meniere’s disease. In addition to sudden and severe vertigo, Meniere’s disease can cause fluctuating hearing loss and buzzing, ringing or a feeling of fullness in your ear. The cause of Meniere’s disease isn’t fully known. Meniere’s disease is rare and typically develops in people who are between the ages of 20 and 40.
  3. Migraine. Dizziness and sensitivity to motion (vestibular migraine) can occur due to migraine headache. Migraine is a common cause of dizziness.
  4. Acoustic neuroma. This noncancerous (benign), slow-growing tumor develops on a nerve that affects your hearing and balance. You might experience dizziness or loss of balance, but the most common

Symptoms

Signs and symptoms of balance problems include:

  1. Sense of motion or spinning (vertigo)
  2. Feeling of faintness or lightheadedness (presyncope)
  3. Loss of balance or unsteadiness
  4. Feeling a floating sensation or dizziness
  5. Vision changes, such as blurriness
  6. Confusion

Treatment

Treatment depends on the cause of your balance problems. Your treatment may include:

  1. Balance retraining exercises (vestibular rehabilitation). Therapists trained in balance problems design a customized program of balance retraining and exercises. Therapy can help you compensate for imbalance, adapt to less balance and maintain physical activity. To prevent falls, your therapist might recommend a balance aid, such as a cane, and ways to reduce your risk of falls in your home.
  2. Positioning procedures. If you have BPPV, a therapist might conduct a procedure (canalith repositioning) that clears particles out of your inner ear and deposits them into a different area of your ear. The procedure involves maneuvering the position of your head.
  3. Diet and lifestyle changes. If you have Meniere’s disease or migraine headaches, dietary changes are often suggested that can ease symptoms. If you experience orthostatic hypotension, you might need to drink more fluids or wear compressive stockings.
  4. Medications. If you have severe vertigo that lasts hours or days, you might be prescribed medications that can control dizziness and vomiting.
  5. Surgery. If you have Meniere’s disease or acoustic neuroma, your treatment team may recommend surgery. Stereotactic radiosurgery might be an option for some people with acoustic neuroma. This procedure delivers radiation precisely to your tumor and doesn’t require an incision.