Balance Disorders

A balance disorder is a complex condition that causes feelings of unsteadiness, wooziness and sensations of spinning, moving or floating. Part of the inner ear known as the labyrinth interacts with other body systems like the eyes, bones and joints to maintain balance. Problems within the vestibular (ear), brain or nervous systems can cause balance problems, which affect over 2 million people each year.

Patients with balance disorders may experience a wide range of symptoms, depending on which system is affected and the severity of this disorder. Symptoms may include:

• Dizziness
• Vertigo
• Lightheadedness
• Blurry vision
• Nausea
• Anxiety
• Faintness

Balance disorders are often the result of another medical condition, such as infections, injuries, blood circulation disorders, medications and aging. Treatment may include treatment of the underlying condition, balance training exercises or lifestyle changes. Surgery may be required for patients whose symptoms do not respond to conservative methods.

Causes

Problems with balance can occur when there is a disruption in any of the vestibular, visual, or proprioceptive systems. Abnormalities in balance function may indicate a wide range of pathologies from causes like inner ear disorders, low blood pressure, brain tumors, and brain injury including stroke.

Many different terms are often used for dizziness, including lightheaded, floating, woozy, giddy, confused, helpless, or fuzzy. Vertigo, Disequilibrium and pre-syncope are the terms in use by most physicians and have more precise definitions.

Vertigo

Vertigo is the sensation of spinning or having the room spin about you. Most people find vertigo very disturbing and report associated nausea and vomiting.

Disequilibrium

Disequilibrium is the sensation of being off balance, and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting.

Pre-syncope

Pre-syncope is a feeling of light headedness or simply feeling faint. Syncope, by contrast, is actually fainting.

Diagnosis

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 physiotherapist or physician for an evaluation. A physician can assess for a medical disorder, such as a stroke or infection, if indicated. A physiotherapist can assess balance or a dizziness disorder and provide specific treatment.

The primary physician may request the opinion of an otolaryngologist to help evaluate a balance problem. An otolaryngologist is a physician/surgeon who specializes in diseases and disorders of the ear, nose, throat, head, and neck, sometimes with expertise in balance disorders. He or she 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 and make additional referrals 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.