A balance disorder is a condition marked by the symptoms of feeling unsteady or dizzy. Even while standing, lying or sitting still, a person with a balance disorder will feel as if they are moving, spinning or floating. While walking, people may feel as if they are tipping over.
Primary symptoms include dizziness or a spinning sensation (vertigo), falling or feeling as if you are going to fall, lightheadedness, faintness, a floating sensation, blurred vision, confusion or disorientation. Other symptoms include nausea and vomiting, diarrhea, changes in heart rate and blood pressure, fear and anxiety or panic attacks.
These disorders can be caused by anything that affects the inner ear or the brain such as medications, ear infections or head injuries. The risk for balance disorders increases as people get older.
What Are the Most Common Balance Disorders?
- Benign Paroxysmal Positional Vertigo (BPPV) involves brief but intense periods of vertigo that are triggered by specific changes in head position. It occurs when tiny crystals in the otolith organs become dislodged and migrate to the semicircular canals.
- Meniere’s disease is a chronic condition that causes vertigo, tinnitus, fullness in the ear and fluctuating hearing loss that may eventually become permanent. Meniere’s is usually confined to one ear and though its cause is unknown it may be the result of abnormal fluid buildup in the inner ear.
- Labyrinthitis is an inflammation of the inner ear usually caused by an infection. Its symptoms include vertigo, temporary hearing loss and tinnitus.
Types of Diagnostic Tests
An ENT physician has a number of diagnostic tests available, ranging from X-rays and CT scans to more in-depth tests. Here are some of the most common:
- Acoustic Immittance Measures. These tests evaluate the eardrum and middle ear and are used to determine which part of the ear is affected by hearing loss.
- Allergy Testing. Used to determine the allergens responsible for triggering an immune system response. These include skin prick and blood tests.
- Audiometry. This hearing exam measures your ability to hear different sounds, pitches and frequencies. It can determine the nature and extent of your hearing loss and whether you will benefit from hearing aids or surgery.
- Auditory Brainstem Response (ABR). This neurologic test provides information about the electrical activity in the auditory pathway between the inner ear and the brain, and measures a person’s hearing sensitivity.
- Electrocochleography. This test is used to determine whether there is excess fluid in the inner ear by measuring the electrical currents generated by sound stimulation, and can help with the diagnosis of Meniere’s disease and other balance and hearing disorders.
- Electronystagmography (ENG). This test measures eye movements in order to assess the functioning of the vestibular system, responsible for balance.
- Otoacoustic Emissions (OAE). This test measures the response of hair cells in the inner ear when stimulated, and can indicate the presence of a conductive or cochlear hearing loss.
- Posturography. This balance test measures the effectiveness of the somatosensory system, vestibular system, and vision to determine which area(s) to focus on when treating a balance disorder.
- Videonystagmography. This test measures eye movements to evaluate the inner ear and central motor functions. It can determine whether a vestibular disorder is the cause of a balance problem, and where one or both ears are affected.
How Are Balance Disorders Treated?
In order to determine the appropriate treatment plan for you, your audiologist will need to evaluate and diagnose your symptoms. Once determined, your audiologist will target the underlying condition in order to reduce or eliminate the symptoms. Options include:
- Medications (antihistamines, sedatives, antibiotics or steroids).
- Physical or occupational therapy.
- Repositioning exercises.
- Vestibular retraining programs.
- Lifestyle modifications (such as dietary changes and elimination of alcohol and nicotine).
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