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Reviewed by

Dr. Jayanthi T V

Consultant - ENT

Manipal Hospitals, Malleshwaram

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Balance Disorder: Common Causes And Treatment

Reviewed by:

Balance is the ability to keep yourself upright and steady while standing or moving and the ability to recover if you trip. A good balance needs coordination between several body parts: your brain, inner ear, eyes, muscles, bones, and joints. Issues with any of these parts can affect your balance. In this article, we’ll cover what balance disorders are, what causes them, their symptoms, and how doctors diagnose and treat them.

What Are Balance Problems?

Your sense of balance helps you remain upright and stable as you go about your daily activities. It depends on a continuous exchange of information between your ears, eyes, tissues, and brain. When this flow of information is disrupted, your balance can be affected. Balance issues can indicate underlying medical conditions. Healthcare providers address this by treating the root cause, and physical therapy for balance issues might also be recommended.

How Does Sense of Balance Work?

Your sense of balance is governed by the interaction between your central nervous system (brain) and your sensory system. Your sensory system comprises:

Symptoms that Indicate Balance Problems

Signs and symptoms of sudden loss of balance include:

Sense of motion or spinning
Loss of balance or unsteadiness
Feeling of faintness or lightheadedness
Falling or feeling like you might fall
A floating sensation or dizziness
Vision changes
Confusion

Causes of Balance Problems

Balance problems can stem from various issues: Here are the main loss of balance causes:

1. Sense of Spinning (Vertigo)

Benign Paroxysmal Positional Vertigo (BPPV): Spinning sensation when changing head positions
Vestibular Neuritis: Inflammation of inner ear nerves, causing severe, lasting dizziness and nausea
Persistent Postural-Perceptual Dizziness: Unsteadiness and motion sensitivity, worsening with moving objects or busy environments
Meniere's Disease: Sudden vertigo with hearing loss, ringing, or fullness in the ear
Migraine: Dizziness or sensitivity to motion during a migraine
Acoustic Neuroma: Slow-growing tumour affecting hearing and balance, causing dizziness and hearing loss
Ramsay Hunt Syndrome: Shingles-like infection causing vertigo, ear pain, and facial weakness
Head Injury: Vertigo from a concussion or other head trauma
Motion Sickness: Dizziness from travel or amusement park rides

2. Feeling Faint or Lightheaded

Orthostatic Hypotension: Lightheadedness from standing up too quickly
Cardiovascular Issues: Problems like irregular heartbeats or blocked blood vessels reducing blood flow

3. Loss of Balance or Unsteadiness

Vestibular Problems: Issues with the inner ear affecting balance
Peripheral Neuropathy: Nerve damage in the legs causing walking difficulties
Joint, Muscle, or Vision Issues: Weak muscles, unstable joints, or vision problems leading to imbalance
Medications: Certain drugs can cause balance issues
Neurological Conditions: Diseases like Parkinson's or cervical spondylosis

4. General Dizziness

Inner Ear Problems: Vestibular system issues causing a floating sensation
Psychiatric Disorders: Conditions like depression and anxiety can cause dizziness
Hyperventilation: Rapid breathing due to anxiety causing lightheadedness
Medications: Some drugs can lead to dizziness

How Do Doctors Diagnose Balance Issues?

To diagnose balance problems, our experienced ENT doctors in Bangalore start with a physical exam, asking about your symptoms and medical history. They often use a series of tests, known as a vestibular test battery, including:

Videonystagmography (VNG): You wear special goggles that track your eye movements while you perform tasks, such as following a target and moving your head.
Rotary Chair: You sit in a motorised chair that moves back and forth while wearing goggles. This test checks how well your eyes and ears work together. You'll keep your eyes open and answer questions as the chair moves.
Modified Clinical Test of Sensory Interaction on Balance (mCTSIB): You stand on a foam or firm surface with and without your shoes, with your eyes open and closed. This test assesses how touch, vision, and inner ear signals affect your balance.
Video Head Impulse Test (VHIT): You wear goggles that record your eye movements as your head is moved quickly in different directions. This test checks how your eyes and ears respond to sudden head movements.
Vestibular-Evoked Myogenic Potentials (VEMP): While sitting and turning your head, you listen to a series of tones. This test examines specific parts of your inner ear system.
Dynamic Visual Acuity Testing (DVA): You look at a computer screen and identify a target while keeping your head still, and then while moving your head. This test evaluates how well your balance system works during head movements.

Treatment Options for Balance Problems

To treat balance disorders, it’s important first to identify the cause. If the problem stems from an ear issue, such as an infection, treating the underlying problem can often alleviate dizziness or vertigo. Common treatment approaches include:

Medication: Prescription drugs like anti-nausea medications, steroids, migraine medications, or antibiotics can help relieve dizziness or vertigo. Over-the-counter medications for dizziness, such as meclizine, Antivert, and bonine, can worsen balance issues and should generally be avoided by patients with balance problems.
Balance (Vestibular) Therapy: The therapy aims to improve balance function and is often used to treat various balance disorders.
Behavioural Change: Adjusting lifestyle factors, such as reducing sodium intake, can help lessen the effects of balance disorder.
Surgery: In severe cases, doctors may perform surgery to stabilise the inner ear or use procedures to disconnect the inner ear from the brain to prevent coordination issues.

When to See a Doctor?

Feeling dizzy from being sick, tired, drunk, or taking certain medications is normal. Some people also feel dizzy when they're hungry or anxious.

But if you have ongoing balance problems, it could be a sign of a serious health issue. Getting checked can help and might even be life-saving.

See a doctor if you:

Have dizziness so severe that you can’t walk or drive safely
Experience dizziness that lasts more than a few days
Have regular bouts of dizziness with no clear cause
Feel dizzy and confused

Visit Emergency Care Room if:

You feel dizzy after a fall or car accident
You have signs of a stroke, like slurred speech or numbness on one side of your body

Most people have felt off-balance at some point, but if balance problems keep happening, they might signal a medical issue. Losing your balance can be confusing and scary, and it can impact your daily life. If you're worried about your balance, talking to an ENT Specialist is a good idea.

FAQ's

How can you reduce your risk of balance problems?

It’s important to follow a healthy lifestyle, including sleeping well, exercising regularly, and following a healthy, balanced diet. Also, be aware of stress levels and practice stress-management techniques such as mindfulness, meditation, yoga, Pilates, and other relaxing activities or hobbies.