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Vestibular Balance Disorder

Dizziness and vertigo are classic symptoms of a vestibular balance disorder. Balance disorders can strike at any age but are most common as people get older.

Your ear is an intricate system of bone and cartilage. Within it is a complex network of canals, called semicircular canals, and fluid-filled pouches, called the otolithic organs. These structures contribute to your sense of balance. Part of this system includes the cochlea, a spiral that also helps you hear. All of these delicate elements make up the vestibular system.

Anatomy of the ear
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Your sense of balance is made up of the way that your senses, such as sight and hearing, define the interaction of gravity and motion. For example, as you move, the fluid in the otolithic organs moves with you. This contributes to your brain's assessment of balance. Likewise, the semicircular canals assess the sensation of movement, as fluid in the canals moves over highly sensitive hairs within those canals.

Causes of vestibular balance disorders

These are common causes of vestibular balance disorders:

  • Medications

  • Infections

  • Inner ear problems, such as those related to poor circulation in the ear

  • Problems rooted in the brain, such as traumatic brain injury

Signs and symptoms

These are symptoms of a vestibular balance disorder:

  • Dizziness

  • Feeling off-balance

  • Feeling as if you are floating or as if the world is spinning around you 

  • Blurred vision

  • Disorientation

  • Falling or stumbling

Less common symptoms include nausea, diarrhea, vomiting, anxiety, fear, and changes in your heart's rhythm.

Complications

These are possible complications of a vestibular balance disorder:

  • Injury because of an increased risk of falling 

  • Reduced quality of life

  • Discomfort

When to call a doctor

Feeling lightheaded or dizzy occasionally happens to most people. If these sensations are frequent and affect your quality of life, contact your doctor.

Diagnosis

You should talk with your health care provider, but you will probably also need to work with an ear, nose, and throat specialist, called an otolaryngologist. Dizziness and lightheadedness can be caused by many conditions. Part of the diagnosis could involve ruling out more common causes in order to find the root of the problem.

The diagnostic process may include:

  • A look at your personal medical history

  • Hearing exam

  • Vision exam

  • Blood tests

  • Imaging tests of the head and brain

  • Clinical tests of balance

  • A look at your posture and movement using a structured, monitored exam called a posturography

Treatment

Treatment will depend on the specific cause of your balance disorder and may include:

  • Treating any underlying causes. Antibiotics or antifungal treatments may be needed to treat an ear infection that's causing your balance disorder.

  • Changes in lifestyle. Some symptoms may be relieved by changes in diet and activity.

  • Rehabilitation. People who are struggling with vestibular balance disorders may need vestibular rehabilitation or balance retraining therapy. This is a therapeutic approach specifically designed to help you move through your day safely. A rehabilitation specialist will help you learn how to cope with dizziness in your daily life. You may need to learn better safety strategies and make adjustments for:

    • Going up and down stairs

    • Driving (ask your doctor when it will be safe for you to drive)

    • Walking and exercising

    • Using the bathroom

    • Organizing your home to make it safer, such as tightening handrails

    • Changing your shoes or clothing, such as wearing low heeled shoes

    • Changing your daily habits, such as planning your day so that you won't be walking in the dark

    • Learning how to use a cane or walker