Balance Disorders: Types and Treatment
- Publish Date: 2015/08/19 - (Rev. 2017/04/06)
- Author: Thomas C. Weiss
- Contact : Disabled World
Outline: Information regarding balance disorders including various types and treatment options.
People who have ever felt lightheaded, dizzy, or as if the room is spinning around them are aware these may be very troublesome sensations. If the feeling occurs often, it might be a sign of a balance issue. Balance issues are among the most common reasons that older adults pursue assistance from a doctor. In the year 2008 alone, an estimated 14.8% of American adults experienced a dizziness or balance issue during the year.
Vertigo is a subtype of dizziness in which a patient inappropriately experiences the perception of motion (usually a spinning motion) due to dysfunction of the vestibular system. It is often associated with nausea and vomiting as well as a balance disorder, causing difficulties with standing or walking. Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo - the sudden sensation that you're spinning or that the inside of your head is spinning.
Having good balance means having the ability to control and maintain your body's position, whether you are moving or being still. An intact sense of balance helps a person to:
- Walk without staggering
- Bend over without falling
- Climb stairs without tripping
- Rise from a chair without falling
The portion of the inner ear responsible for balance is the, 'vestibular system,' many times referred to as the, 'labyrinth.' To maintain the position of your body, the labyrinth interacts with additional systems in your body such as your bones, joints, or eyes. Good balance is important to help you move around, remain independent, as well as pursue activities of daily living.
Seniors and Issues with Balance
As people age, many of us experience issues with our sense of balance. People feel unsteady or dizzy, or as if they or their surroundings are in motion. Disturbances of the inner ear are a common cause. Vertigo, the feeling that you or the objects around you are spinning, is a common symptom.
Balance disorders are one reason seniors fall. Falls and fall-related injuries such as hip fracture may have a serious impact on a senior's life. If you fall it might limit your activities or make it impossible to live on an independent basis. Many seniors become more isolated after a fall.
According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults over the age of 65 fall every single year. Among seniors, falls are the leading cause of injury-related deaths. Falls most often do not result in an injury, or they result in minor cuts and bruises, yet they sometimes affect a person's physical or mental health. At least one-tenth of falls result in serious injury to the person's bones or soft tissues. A fall may cause a head injury, fracture, or other issue that can change the person's life.
Fractures caused by falls can lead to disability and hospital stays. Fractures may also prevent a senior from getting around, socializing, or performing daily tasks. Most of the time, fall-related fractures are in the person's pelvis, spine, hand, arm, or ankle. Fear of falling again can cause issues as well. A person who has fallen might avoid enjoyable activities or performing daily tasks. Fear of falling can also cause the person to spend more time at home and away from others.
Benign Paroxysmal Positional Vertigo (BPPV)
A number of types of balance disorders exist. One of the most common ones is benign paroxysmal positional vertigo, or BPPV. With BPPV, a person experiences a brief yet intense feeling of vertigo when they change the position of their head, such as when rolling over to the right or left, after getting out of bed or when looking for an object on a low or high shelf. BPPV is more likely to occur in adults over the age of 60, although it may also occur in people who are younger.
In BPPV, small calcium particles in the person's inner ear become displaced and disrupt the inner ear balance sensors, causing dizziness. The reason they become displaced remains unknown, the cause might be a head injury, inner ear infection, or simply aging. Other types of balance disorders include:
Labyrinthitis: Labyrinthitis is an infection or inflammation of the inner ear, causing dizziness and loss of balance. It is often associated with an upper respiratory infection such as the flu.
Meniere's Disease: Meniere's disease is a balance disorder that causes a person to experience vertigo, tinnitus, hearing loss that comes and goes, as well as a feeling of fullness in the person's ear. It affects adults of any age and the cause remains unknown.
Diagnosing Balance Disorders
Diagnosing a balance disorder is hard. To find out if you have a balance issue, a doctor might suggest that you see an, 'otolaryngologist.' An otolaryngologist is a doctor and surgeon who specializes in diseases and disorders of the nose, ear, throat and neck. An otolaryngologist may ask a person to have a hearing examination, an electronystagmogram, blood tests or imaging studies of the person's brain and head. Another potential test is called, 'posturography.' In this test, a person stands on a special movable platform in front of a patterned screen. The person's doctor measures how their body responds to movement on the platform, the patterned screen, or both.
Treating Balance Disorders
The first thing a doctor will do if a person has balance issues is determine if another health condition or medication is to blame. If this is the case, a doctor will treat the condition, suggest a different medication, or refer the person to a specialist if the condition is outside of the doctor's expertise.
If you have BPPV, a doctor may recommend a series of simple movements such as the, 'Epley maneuver,' which may help dislodge the otoconia from the semicircular canal. In many instances one session works. Others need the procedure a number of times to gain relief from dizziness.
If you are diagnosed with Meniere's disease, a doctor might recommend that you make some changes to your diet. If you smoke, a doctor may suggest you quit. Anti-vertigo or anti-nausea medications might relieve your symptoms, yet they may also make you drowsy. Additional medications such as gentamicin or corticosteroids may be administered. While gentamicin might reduce dizziness better than corticosteroids, on occasion it causes permanent loss of hearing. In some severe instances of Meniere's disease, surgery on the vestibular organs might be needed.
Some people with a balance disorder may not be able to completely relieve the dizziness they experience and need to find ways to cope with it. A vestibular rehabilitation therapist can help to develop an individualized treatment plan. Contact your doctor about whether or not it is safe to drive, as well as ways to decrease your risk of falling and getting hurt during your daily activities, such as when you walk up or down stairs, exercise, or use the bathroom. To cut your risk of injury from dizziness, avoid walking in the dark. You should also wear low-heeled shoes or walking shoes outdoors. If needed, use a walker or a cane and modify conditions at your workplace or at home, perhaps by adding handrails.
There are three types of vertigo.
- The first - Known as objective and describes when the patient has the sensation that objects in the environment are moving.
- The second - Known as subjective and refers to when the patient feels as if they are moving.
- The third - Known as pseudovertigo, an intensive sensation of rotation inside the patient's head.
- 1 - Meniere's Disease: Causes and Prevention | University of Colorado Denver (2013/12/12)
- 2 - Vertigo and Meniere's Disease: Feeling Dizzy | Mark Parsec (2009/07/07)
- 3 - Balance Disorders: Types and Treatment | Thomas C. Weiss (2015/08/19)
- 4 - Vertigo: Brandt-Daroff Exercises for Balance Disorders | Disabled World (2009/07/07)
- 5 - Progressive Supranuclear Palsy: Facts & Information | Disabled World (2010/04/14)