Dizzy spells are not confined to the heroines in Victorian novels or those who hit the bottle to drown their sorrows. Imagine sitting up and the world around you suddenly spinning; or walking and suddenly feeling you are tipping over, with your limbs flailing to maintain balance. For people with a condition called balance disorder, this is a constant reality.
How Do We Maintain Balance?
Pressure sensors across the body send signals to your body about how it stands in relation to the world. This is called proprioception. These signals are processed in the inner ear, where thousands of sensory hair cells and clusters of tiny hair-like extensions called hair bundles are at work. The hair bundles are activated by sounds and open up channels to create electrical signals that send information to the brain. The brain uses this information, along with cues from your eyes, bones, and joints, to help maintain balance.1
What Is Balance Disorder?
Recurrent or ongoing spells of dizziness that make you lose balance are termed as balance disorder. Whether it’s lightheadedness, a fleeting spell of faintness, or the world around you going into a spin ever so often, balance disorder can strike in different ways. These spells may come and go or may last for a long time. The condition can impact daily activities and have an emotional and psychological impact when it is intense.
Symptoms Of Balance Disorder
If you have a balance disorder you may:
- Stagger when you try to walk
- Teeter or fall when you try to stand up
- Feel dizzy constantly or recurrently
- Feel like you are floating
- Feel disoriented or confused
- Experience vertigo, an intense sensation of spinning
- Feel lightheaded
- Experience blurred vision
- Feel nauseous
- Feel anxiety, fear, or panic
If these signs last long or keep recurring in short intervals, they can cause fatigue, depression, and social anxiety.2
What Causes Balance Disorders?
The most common medical conditions that cause balance disorder are related to the inner ear. Other triggers include ear infections, low or high blood pressure, a head injury, or any other problems that affect the brain.
In some instances, balance disorders start suddenly and have no obvious cause. Certain medication that are toxic to the ear can also be responsible. So can conditions such as eye muscle imbalance or arthritis – basically disorders that affect your visual or skeletal system.3
The risk of balance disorders increases with age. This is because our multisensory motor control decreases with advancing age, contributing to dizziness or postural imbalances.4
6 Types Of Balance Disorders
One of these conditions may be responsible for your balance disorder.
1. Positional Vertigo Or Benign Paroxysmal Positional Vertigo (BPPV)
In this condition, a short but intense episode of vertigo is triggered by a change in the position of the head. It could happen because of an injury or just because of age. Displaced otoconia in the inner ear – small crystals of calcium carbonate – stimulate nerve cells that send signals to the brain and cause vertigo. If you have BPPV, tilting your head, looking over the shoulder, rolling over in bed, or just bending could bring on a bout of intense vertigo.5
This is an inner ear infection. There is a delicate structure called the labyrinth deep inside your ear. An infection to this structure results in inflammation and is called labyrinthitis. The infection affects your balance as well as your hearing. It is often associated with upper respiratory infections such as the flu.6
3. Ménière’s Disease
Ménière’s disease is linked to changes in the volume of fluid in some parts of the labyrinth. If you suffer from Ménière’s disease, you will experience episodes of vertigo, hearing loss, and buzzing in the ear.7
4. Vestibular Neuronitis
In this condition, the vestibular nerve gets inflamed due to a viral infection. If you have this condition, you will experience vertigo.8
5. Perilymph Fistula
This is a condition in which inner ear fluid leaks into the middle ear. If this has happened, you will feel unsteady and any activity will increase the unsteadiness. You may even feel nauseous and dizzy. A head injury, ear surgery, an infection, or physical exertions such as scuba diving which bring about dramatic changes in air pressure can cause the condition.9
6. Mal de Debarquement (MdDS)
This is a feeling of continuous bobbing or rocking. This typically occurs after long sea travel. The symptoms generally go away in a few hours or after some rest after your travel has ended.10
Treatment For Balance Disorders
If you have a balance disorder, possible health conditions that cause this disorder will be looked into. Any medication that you take will also be evaluated as a possible cause.
For instance, if you are diagnosed with BPPV, some simple movements will be recommended to help dislodge the otoconia from the semicircular canal. These movements are called the Epley maneuver. These maneuvers should be performed only by trained medical professionals to rule out neck/back injury.
Similarly, if it is Ménière’s disease that you are battling, your doctor may recommend some lifestyle and dietary changes.11 You will need to:
- Limit your salt intake
- Cut down on smoking
- Limit alcohol consumption
- Cut down caffeine consumption
Medication to control your symptoms will be prescribed and, in severe cases, surgery may be advised. A vestibular therapist can create a customized treatment plan to help you cope with your dizziness. You may also be taught vestibular rehabilitation exercises.12
Precautions To Take If You Suffer From Balance Disorder
Make changes around the house to minimize your risk of getting hurt due to falls – for instance, adding handrails. Switch to low-heeled shoes or walking shoes and, if needed, start using a cane or walker. Talk to your doctor about whether it’s safe for you to drive.13
|↑1||NIH researchers show protein in inner ear is key to how cells that help with hearing and balance are positioned. National Institute on Deafness and Other Communication Disorders.|
|↑2, ↑3||Balance Disorders. National Institute on Deafness and Other Communication Disorders.|
|↑4||Brandt, Thomas. Vertigo: Its multisensory syndromes. Springer Science & Business Media, 2013.|
|↑5||BPPV Treatment. Vestibular Disorders Association.|
|↑7||Gürkov, R., I. Pyykö, J. Zou, and E. Kentala. “What is Meniere’s disease? A contemporary re-evaluation of endolymphatic hydrops.” Journal of neurology 263, no. 1 (2016): 71-81.|
|↑8||Vestibular neuronitis. NHS UK.|
|↑9||Perilymph fistula. American Hearing Research Foundation.|
|↑10||Mal de Debarquement. American Hearing Research Foundation.|
|↑11||Balance Problems. NIH Senior Health|
|↑12||Vestibular rehabilitation therapy. Vestibular Disorders Association.|
|↑13||Balance Disorders. NIDCD|