Introduction
Balance disorders are when a patient finds it difficult to gain balance while standing, walking, or lying down. This occurs when one is unable to control the body’s position. The patients may experience dizziness, blurred vision, disorientation, and vertigo (a feeling of the head-spinning or the surroundings spinning).
Balance is attained when the overall body works in an oriented manner; when any of these systems are affected, then it could be manifested as a balance disorder. Balance disorders are a common manifestation of different medical conditions, the most common among them being vestibular balance disorders like labyrinthitis and vestibular neuritis. Vestibular neuritis is a medical condition where the vestibular nerve gets affected, whereas labyrinthitis is inflammation of the labyrinth. Most of which do not require medical attention. When there is a balance disorder, one should consult a doctor to rule out serious medical conditions like stroke or tumor.
What Are the Causes of Balance Disorders?
Vestibular balance disorders, including labyrinthitis and vestibular neuritis, can be caused by different medical conditions. These conditions can be explained based on the signs and symptoms seen with them.
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Benign Paroxysmal Positional Vertigo (BPPV)- This is a condition in which a calcium crystal-like particle in the inner ear is displaced from its position and is freely moving in the inner ear. BPPV is the most common cause of vertigo.
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Persistent Postural Perceptual Dizziness- This is a chronic vestibular balance disorder that is characterized by postural instability and non-spinning vertigo. These symptoms are aggravated by seeing objects moving in an upright position and by visually complex stimuli.
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Vestibular Neuritis- Vestibular neuritis is a condition affecting the inner ear and is characterized by severe vertigo, balance problems, nausea, and vomiting.
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Migraine- Migraine can cause dizziness.
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Meniere’s Disease- It is one of the vestibular balance disorders that affects the inner ear and can cause vertigo and hearing loss.
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Acoustic Neuroma- Acoustic neuroma is a benign tumor that develops on the vestibular or cochlear nerve leading to the brain. This is characterized by vestibular balance disorder and hearing loss depending upon the nerve affected.
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Motion Sickness- While traveling in vehicles or boats, people can experience dizziness because of motion sickness. This may be due to vestibular balance disorders like labyrinthitis and vestibular neuritis.
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Head Injury- A concussion or other head injury can cause vertigo and other balance-related issues.
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Postural Hypotension- Suddenly standing upright from lying down or sitting position can cause a sudden fall in blood pressure and cause lightheadedness or fainting.
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Cardiovascular Diseases- Heart-related issues that affect the blood flow can result in lightheadedness and fainting.
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Medications- Certain medications can have side effects such as loss of balance and lightheadedness.
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Inner Ear Problems- Abnormality of the vestibular system can cause vertigo and other balance-related problems.
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Joint, Muscle, and Vision Problems- When a person has any problem related to joint, muscle, or vision, then they find it difficult to walk and have a steady balance.
What Are the Signs and Symptoms of Balance-Related Problems?
The signs and symptoms of balance disorders include:
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Dizziness and vertigo (feeling of spinning of the head or the surroundings).
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Falling or feeling about to fall.
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Difficulty when trying to walk.
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Lightheadedness.
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Fainting.
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Blurred vision.
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Disorientation.
How Are Balance Disorders Diagnosed?
The doctor will be reviewing the medical history and will be doing physical and neurological tests. To find out if the balance problems are caused due to problems related to the inner ear, the following tests are carried out:
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Hearing Tests- Problems related to the balancing part of the inner ear are often associated with hearing problems as well.
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Posturography Test- This test is done by wearing equipment and standing on a moving platform. This test is done to identify which part of the balance system relies most on balance.
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Rotary Chair Test- The eye movements are monitored while the patient is seated in a computer-controlled chair that rotates slowly.
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Blood Pressure and Heart Rate Tests- Blood pressure and heart rate are monitored to identify if the cause is due to any cardiovascular-related problem.
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Electronystagmography- It is a test that uses electrodes to record eye movement.
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Videonystagmography- This is a test that uses a camera to record eye movements.
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Imaging Tests- MRI and CT scans are used to diagnose any other underlying cause for this disorder.
How Are Balance Disorders Treated?
The balance-related diseases are treated according to the cause of the disease. The treatment may include:
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Vestibular Rehabilitation: This program includes various balance-regaining exercises customized for each patient and is executed by therapists trained in balance problems.
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Positioning Procedures: This is done in patients with BPPV, in whom the therapist will advise certain exercises that will aid the calcium crystals to move out from the dislocated position and deposit in another place. The procedure involves maneuvering the position of the head.
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Lifestyle Changes: If Meniere's disease or migraine is the cause of the balance disorder, then dietary modifications are required. The intake of triggering foods like caffeine, alcohol, and other ingredients needs to be limited. In the case of postural hypotension, one must increase the amount of fluid intake.
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Medications: In case of severe vertigo, the doctor will prescribe medications that can control dizziness and vomiting.
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Surgery: When the cause is Meniere’s disease or acoustic neuroma, the doctor will advise surgery.
When to Consult a Doctor for Balance Disorders?
Consult a doctor when having the following problems along with balance problems:
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Headache and neck pain.
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Fainting and falling
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Vomiting.
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Affects the day-to-day activities.
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Longer duration.
What Are the Complications of Balance Disorders?
The complications associated with balance disorders are:
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Possible injuries from falling.
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Affects the quality of life.
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Limits the freedom to move around independently.
Conclusion
Vestibular balance disorders are associated with various medical conditions. The most common among these are inner ear problems, which greatly affect the balance along with hearing problems. Balance disorders greatly affect the quality of life as they can affect the day to day living. The symptoms include vertigo, lightheadedness, dizziness, blurred vision, and disorientation. These patients are prone to falling and injuring themselves and should have someone along with them as it is better. If someone has balance issues, they must consider consulting a doctor to rule out other serious conditions that can cause this, too, like stroke and tumor.
