Dizziness and vertigo are symptoms of a vestibular balance disorder. Balance disorders can strike at any age, but are most common as you get older.
Your ear is a complex system of bone and cartilage. Within it is a network of canals. These are called semicircular canals. The canals are filled with fluid. The position of the fluid changes with movement. A sensor in the ear then sends the information to your brain to contribute to your sense of balance. These and other delicate pieces make up the vestibular system.
Certain things can affect the signals from any of the parts of the vestibular system causing symptoms.
Common causes of vestibular balance disorders include:
- Inner ear problems, such as poor circulation in the ear
- Calcium debris in your semicircular canals
- Problems rooted in your brain, such as traumatic brain injury
The symptoms of a vestibular balance disorder include:
- Feeling off-balance
- Feeling as if you are floating or as if the world is spinning
- Blurred vision
- Falling or stumbling
Less common symptoms include:
- Changes in your heart's rhythm
- Hearing exam
- Vision exam
- Blood tests
- Imaging tests of the head and brain
- Clinical tests of balance
- Look at your posture and movement, using a structured, exam called a posturography
Treatment will depend on the cause of your balance disorder and may include:
- Treating any underlying causes. Depending on the cause, you may need antibiotics or antifungal treatments. These can treat ear infections that are causing your balance disorder.
- Changes in lifestyle. You may be able to ease some symptoms with changes in diet and activity. This includes quitting smoking or avoiding nicotine.
- Epley maneuver (Canalith repositioning maneuvers). These are a specialized series of movements of your head and chest. The goal is to reposition particles in your semicircular canals into a position where they don’t trigger symptoms.
- Surgery. When medicine and other therapies are unable to control your symptoms, you may need surgery. The procedure depends on the underlying cause of the disorder. The goal is to stabilize and repair inner ear function.
- Rehabilitation. If you struggle with vestibular balance disorders, you may need vestibular rehabilitation or balance retraining therapy. This helps 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 healthcare provider 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 shoe
- 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
Possible complications include:
- Injury from falling
- Reduced quality of life
The symptoms of vestibular balance disorder can interfere with regular daily activities and your ability to drive, work, or enjoy recreation activities. This can cause symptoms of depression and frustration. Counseling can help you learn to cope with the disorder and life style impacts.
Feeling lightheaded or dizzy occasionally happens to most people. If these sensations are frequent and affect your quality of life, contact your healthcare provider.
- Vestibular balance disorders can affect orientation and balance.
- Treatment depends on the underlying cause and can include medicine, rehabilitation, and lifestyle changes. You may need surgery for symptoms that do not resolve with other treatments.
- Talk to your healthcare provider if you have symptoms of vertigo, dizziness, or hearing changes. These can mean you have a vestibular balance disorder.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
January 16, 2018
Mancini, M. The relevance of clinical balance assessment tools to differentiate balance deficits. European Journal of Physical Rehabilitation MEdicine (2010)46(2); 239-248, Pathophysiology, etiology, and differential diagnosis of vertifo, Up To Date, Benign paroxysmal positional vertigo, Up To Date, Approach to the patient with dizziness, Up To Date, Evaluation of the patient with vertigo, Up To Date
Kacker, Ashutosh, MD,Freeborn, Donna, PhD, CNM, FNP