BALANCE DISORDERS

While many balance disorders are idiopathic (no known cause) there are treatment options for specific diseases. It's important to accurately describe symptoms so the physician can correctly diagnose the specific disorder and begin treatment. The most common vestibular disorders are:

BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)

Symptoms of BPPV include dizziness and vertigo when changing head position, such as tilting the head up or rolling over in bed. BPPV disorder is caused by debris that has accumulated in the inner ear. The debris is made up of tiny calcium carbonate crystals (otoconia).

When changing head position the displaced otoconia may shift, resulting in a feeling of vertigo or imbalance. Approximately 20 percent of dizziness can be attributed to BPPV. In the elderly population 50 percent of dizziness is due to BPPV. The most common cause of BBPV is head trauma. BPPV is also more common in the elderly due to degeneration within the vestibular system. BPPV has also been found to be associated with migraine headache. BPPV may be treated with a canalith repositioning maneuver and vestibular rehabilitation.

LABYRINTHITIS

Labyrinthitis is a viral or bacterial infection of the vestibulocochlear nerve in the inner ear. The labyrinth becomes inflamed resulting in symptoms of vertigo, dizziness, disequilibrium, nausea, and hearing changes. The labyrinth sends information to the brain in regard to the position of your head. The disturbance in the inner ear can lead to distorted information being sent to the brain. The onset of symptoms is usually very sudden and may last several weeks. Treatment for viral infection is different than treatment for bacterial infection, therefore it's important to get an accurate diagnosis from your physician. In some cases there is permanent damage to the vestibular system, resulting in hearing loss and ongoing symptoms of dizziness and vertigo. Treatment options for labyrinthitis include medication to treat the infection and vestibular rehabilitation exercises.

DISEQUILIBRIUM OF AGING

Nerve cells in the vestibular system degenerate as we age. Prioproception, muscle and bone strength also decrease, resulting in a feeling of disequilibrium. Other factors of aging can cause imbalance, including diseases of the eye (glaucoma, cataracts, macular degeneration), diseases of the bone and muscles, and sedentary lifestyle. It's important to rule out the possibility of a more serious condition, such as stroke or tumor, which can cause balance problems. Balance retraining may be indicated to compensate for the feeling of imbalance, reduce the symptoms of dizziness and vertigo, and to limit the risk of falling.

OTOTOXICITY

Balance disorder or hearing loss caused by certain medications that can damage the inner ear. Some antibiotics, diuretics, and aspirin can cause ototoxicity. Some anticancer drugs have been shown to cause hearing loss. Many environmental chemicals such as mercury, lead, and carbon monoxide have been linked to balance problems. Symptoms can vary widely depending on the individual and type of drug. They range from a feeling of imbalance, tinnitus, and complete hearing loss. Some patients have a feeling of fullness in their ears, blurred vision, and trouble walking. The damage is usually irreversible but vestibular rehabilitation can be helpful. A hearing aid or cochlear implant may be indicated in patients with severe bilateral hearing loss.

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