Vertigo Balance Disorders

Vertigo or balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating, and loss of balance. Causes of dizziness related to the ear are often characterized by vertigo (spinning) and nausea.

Vertigo is a serious disease as it increases the risk factor for some of the serious disorders such as strokes and tumors. There are different types of vertigo such as peripheral vertigo, objective vertigo and central vertigo, hence, the treatment of the vertigo is a necessity as it may lead to severe imbalance problems.

The human balance system works with our visual and skeletal systems to maintain orientation or balance. Visual signals are sent to the human brain about the body's position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular, visual and the skeletal systems.

Balance Problems related to the ear or the brain

1 - Ear Related Balance Conditions

Bilateral Vestibulopathy - a condition caused by loss of inner ear balance function.

Benign Paroxysmal Positional Vertigo (BPPV) - The most common cause of vertigo described as a brief, intense sensation of spinning that occurs because of a specific change in the position of head such as getting out of bed in the morning, or getting up from a chair too quickly. (See below for Brandt-Daroff exercises and other exercises to assist BPPV)

Labyrinthitis - Inner ear infection or inflammation causing both dizziness (vertigo) and hearing loss.

Ménière's Disease - Inner ear fluid balance disorder that causes lasting episodes of vertigo, fluctuating hearing loss, tinnitus (a ringing or roaring in the ears), and/or the sensation of fullness in the ear.

Perilymph Fistula - a leakage of inner ear fluid from the inner ear.

Superior Canal Dehiscence Syndrome - Loss of balance and hearing disorder caused by a gap in the temporal bone, leading to the dysfunction of the superior canal.

2 - Brain Related Balance Conditions

CNS or Posterior Neoplasms: Benign or Malignant.

Degenerative: Age related decline in balance function.

Infectious: Meningitis, encephalitis, epidural abscess, Syphilis

Circulatory: Cerebral or Cerebellar ischemia or hypoperfusion, Stroke, Lateral medullary syndrome (Wallenberg's syndrome)

Autoimmune: Cogan syndrome

Structural: Arnold-Chiari malformation, Hydrocephalus

Systemic: Multiple Sclerosis, Parkinson's Disease

There are other causes of dizziness not related to the human ear:

Mal de Debarquement - (land legs or sea legs) a disorder of imbalance caused by being on a ship. Patients feel sea sick even when they get off the ship.

Motion Sickness - a conflict between the input from the various systems involved in balance causes an unpleasant sensation.

How To Treat Vertigo

There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, such as ear infection, stroke, or multiple sclerosis. Individual treatment will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests. Most types of balance disorders will require balance training, prescribed by a physiotherapist.

The disease is usually treated symptomatically since it will help to reduce the severity of manifestations. The problem is in the inner ear, which includes dislocation of calcium crystals and infections such as Benign Positional Paroxysmal Vertigo (BPPV) and can be treated with certain exercises such as physical maneuvers. However, brain damage or cardiac problems are more serious and hence have to be treated very carefully.

Particle repositioning maneuver is a specific treatment for vertigo caused by mis-positioning of calcium carbonate crystals. In the treatment the head has to be moved in such a manner to reposition the crystals and to give relief from the symptoms of imbalance.

Drugs for the treatment of vertigo can be administrated orally, through intravenous injections or patches in the skin. In case of any bacterial infections, antibiotics are preferred to stop the further complications. Meclizine hydrochloride, Diphenhydramine, Promethazine Hydrochloride, Diazepam and Scopolamine transdermal patch are some of the commonly used for the treatment of vertigo.

Exercises for BPPV

Exercises for vestibular rehabilitation are also used as remedy for vertigo in which the patient repeatedly undergoes the position change from lying state to sitting and vice versa. This is repeated until the patient has recovered completely and most often, the recurrence of the disease will not occur.

In serious cases, surgery in the inner ear to insert a plug is recommended to overcome the disorder. It has high success rate and only 5% of people have to repeat the treatment.

Rest is the immediate solution to vertigo, as soon as the symptoms are felt. Use of a cane is also sometime necessary to retain steadiness and balance. A patient with a tendency for vertigo must be extremely careful to adjust their movements at a slow pace.

Exercises are a method of treating BPPV (Benign Paroxysmal Positional Vertigo). Exercises include the Epley, Brandt-Daroff exercises, and Semont Maneuvers. These maneuvers are effective treatment in that they help speed up compensation by the brain. When these maneuvers work, they can relieve the symptoms of vertigo very quickly.

Further Information Regarding Vertigo Balance Disorders

Semont Maneuver for Paroxysmal Positional Vertigo
The Semont manuever (also called the "liberatory" maneuver) is effective in ridding the symptoms of benign paroxysmal positional vertigo (BPPV) with a cure rate of 90.3%. The Semont maneuver involves the patient rapidly moved from lying on one side to lying on the other. A single 10 - 15 minute session is usually all that is required.

Epley's Maneuver Video for Vertigo
Dizziness and Positional Vertigo are treatable with the non-invasive, non-drug procedure developed by Dr. John Epley and Dr. Dominic Hughes. This technique is used to manage BPPV, which involves sequential movement of the head into 4 positions.

Vertigo and Meniere's Disease
The world has been spinning out of control now for about fourteen years! I mean that both literally and metaphorically. For it was then that I was diagnosed with a strange disease that I had never even heard of previously. Meniere's Disease or Meniere's Syndrome causes vertigo. You know... that strange sensation that people have when they drink too much and they get the "spins".

Brandt-Daroff Exercises for Vertigo and Balance Disorders
The Brandt-Daroff exercise is one of several exercises intended to speed up the compensation process and end the symptoms of vertigo. Brandt-Daroff exercises are generally used to treat BPPV, and sometimes to treat labyrinthitis or vestibular neuritis, at home and are performed in three sets per day for two weeks.