Saanichton, BC

Dr. Miguel A. Lipka

Balance Disorders

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A balance disorder is a condition that makes you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down.

A balance disorder may be caused by viral or bacterial infections in the ear, a head injury, or blood circulation disorders that affect the inner ear or brain. Many people experience problems with their sense of balance as they get older. Balance problems and dizziness also can result from taking certain medications.

In addition, problems in the visual and skeletal systems and the nervous and circulatory systems can be the source of some posture and balance problems. A circulatory system disorder, such as low blood pressure, can lead to a feeling of dizziness when we suddenly stand up. Problems in the skeletal or visual systems, such as arthritis or eye muscle imbalance, also may cause balance problems. However, many balance disorders can begin all of a sudden and with no obvious cause.

If your balance is impaired, you may feel as if the room is spinning. You may stagger when you try to walk or teeter or fall when you try to stand up. Some of the symptoms you might experience are:

  • Dizziness or vertigo (a spinning sensation)
  • Falling or feeling as if you are going to fall
  • Lightheadedness, faintness, or a floating sensation
  • Blurred vision
  • Confusion or disorientation

Other symptoms include:

  • Nausea and vomiting
  • Diarrhea
  • Changes in heart rate and blood pressure
  • Fear, anxiety, or panic
  • Feeling tired, depressed, or unable to concentrate

Symptoms may come and go over short time periods or last for longer periods of time.

There are more than a dozen different balance disorders. Some of the most common are:

  • Benign paroxysmal positional vertigo (BPPV)
  • Labyrinthitis
  • Ménière's disease
  • Vestibular neuronitis
  • Perilymph fistula
  • Mal de debarquement syndrome (MdDS)

To reduce your risk of injury from dizziness, avoid walking in the dark. You also should wear low-heeled shoes or walking shoes outdoors and use a cane or walker if necessary. If you have handrails in the home, inspect them periodically to make sure they are safe and secure. Modifications to bathroom fixtures can make them safer. Conditions at work may need to be modified or restricted, at least temporarily. Driving a car may be especially hazardous. Ask your doctor's opinion about whether it's safe for you to drive.

The first thing a doctor will do to treat a balance disorder is determine if your dizziness is caused by a medical condition or medication. If it is, your doctor will treat the condition or suggest a different medication.

Your doctor also may describe ways for you to handle daily activities that increase the risk of falling and injury, such as driving, walking up or down stairs, and using the bathroom. If you have BPPV, your doctor might prescribe a series of simple movements, called the Epley maneuver, to help dislodge the otoconia from the semicircular canal.

If you are diagnosed with Ménière's disease, your doctor may recommend changes in your diet, such as reducing the use of salt in your food and limiting alcohol and caffeine. Some anti-vertigo or anti-nausea medications may relieve your symptoms, but they can also make you drowsy. Other medications, such as the antibiotic gentamicin or corticosteroids, may be injected behind the eardrum to reach the inner ear. Surgery on the vestibular organ may be necessary if you have a severe case of Ménière's disease.

Some people with a balance disorder may not be able to fully relieve their dizziness and will have to develop ways to cope with it on a daily basis. A vestibular rehabilitation therapist can help by developing an individualized treatment plan that combines head, body, and eye exercises to decrease dizziness and nausea.