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Balance problem arise when individuals experience disruptions in the communication between their central nervous system and brain, resulting in a feeling of unsteadiness on their feet. Furthermore, these balance problems can manifest as indications of specific medical conditions.
Balance problems can cause dizziness, a whirling sense in the room, unsteadiness, and lightheadedness. Whether lying down, sitting, or standing, people can have the sensation of impending falling.
To maintain appropriate balance, numerous bodily systems must operate correctly. These systems include the heart, blood vessels, nerves, muscles, bones, joints, eyes, and inner ear’s balance organ. Balance problem may be felt when any of these systems have problems or are not operating at their best.
Balance problems can result from a number of medical conditions, but most of them are caused by issues in the vestibular system, the balance organ of the inner ear.
Symptoms
Signs and symptoms of balance problems includes the following:
- Vertigo or sense of motion or spinning
- Lightheadedness or feeling of faintness
- Unsteadiness or loss of balance
- Falling or feeling like falling
- Dizziness or floating sensation
- Confusion
- Blurred vision or other vision changes
Causes
There are several different conditions that might cause balance problems. The underlying cause of these balance issues is typically associated with the specific signs or symptoms exhibited by the individual.
- Vertigo or sense of motion or spinning: There are several conditions that have been related to vertigo, including:
- Benign paroxysmal positional vertigo (BPPV). Calcium crystals in the inner ear that are involved in balancing are displaced from their usual places and shift to different areas of the inner ear in the event of BPPV. The most common cause of vertigo in adults is known to be BPPV. If a person with BPPV turns in bed or tilts their head back to look up, they could feel as though they are spinning.
- Vestibular neuritis: The nerves in the inner ear that control balance may be affected by this inflammatory condition, which is probably brought on by a virus. The symptoms, which frequently include nausea and difficulty walking, are severe and long-lasting. While the symptoms can continue many days without treatment, they frequently get better gradually.
- Migraine: Migraines can cause vestibular migraines, which are characterized by heightened motion sensitivity and dizziness. Dizziness is frequently brought on by migraines.
- Persistent postural-perceptual dizziness: Other forms of vertigo are frequently correlated with this disease. Unsteadiness or a sensation of motion in the head are some of its symptoms. When reading, seeing moving items, or being in visually complex settings like a mall, the symptoms frequently get worse. This condition is the third most common condition in adults.
- Meniere’s disease: Meniere’s disease can cause variable hearing loss, along with buzzing, ringing, or a feeling of fullness in the affected ear, in addition to abrupt and severe vertigo. The precise cause of Meniere’s disease remains unclear. This condition is relatively uncommon and usually manifests in individuals aged between 20 and 40 years.
- Acoustic neuroma: This benign, slowly-growing tumor develops on a nerve that impact hearing and balance. Dizziness and balance problems are possible signs of this disorder, although hearing loss and ringing in the ears are the most common ones.
- Ramsay Hunt syndrome (herpes zoster oticus): Vertigo, ear pain, facial paralysis, and hearing loss are possible symptoms of this condition. It develops when a shingles-like infection affects the facial, auditory, and vestibular nerves close to one of the ears.
- Motion sickness: Traveling on boats, vehicles, planes, or on amusement park rides can cause dizziness. People who experience migraines often suffer from motion sickness as a common symptom.
- Head injury: Vertigo can be experienced as a result of a concussion or other head injury.
- Lightheadedness or feeling of faintness: This can be associated with the following:
- Hemodynamic orthostatic hypotension: For some people, standing or sitting up too rapidly might result in a significant drop in blood pressure, which can make them feel dizzy or faint.
- Cardiovascular disease: Lightheadedness or a sensation of fainting can be caused by abnormal heart rhythms (heart arrhythmia), narrowed or blocked blood vessels, a thickened heart muscle (hypertrophic cardiomyopathy), or a decrease in blood volume, all of which can result in reduced blood flow.
- Unsteadiness or loss of balance: Losing balance while walking or experiencing feelings of imbalance can result from:
- Vestibular problems: A sensation of a floating or heavy head and feelings of unsteadiness in the dark can be caused by abnormalities in your inner ear.
- Peripheral neuropathy: Involves nerve damage to the legs, can result in difficulties with walking.
- Joint, muscle or vision problems: Loss of balance can be contributed by muscle weakness and unstable joints. Additionally, difficulties with eyesight can also lead to feelings of unsteadiness.
- Medications: Certain medications may have a side effect that causes balance loss or unsteadiness.
- Neurological conditions: Parkinson’s disease and cervical spondylosis are two examples of these disorders.
- Dizziness: There are several causes of feeling lightheaded or dizzy, including:
- Medications: Some medications may have a side effect as lightheadedness.
- Inner ear problems: A floating sensation or other false feelings of motion might be caused by vestibular system dysfunction.
- Psychiatric disorders: Dizziness can be caused by depression (major depressive disorder), anxiety, and other psychiatric disorders.
- Abnormally rapid breathing (hyperventilation): The condition usually coexists with anxiety problems and can make one feel dizzy.
Diagnosis
Your doctor will start by reviewing your medical history and conducting a physical and neurological examination.
In order to ascertain the cause of the symptoms related to the balance function in the inner ear, the healthcare provider is likely to recommend a series of tests. These tests may encompass:
- Imaging tests: In order to ascertain whether underlying medical diseases might be the cause of balance problems MRI and CT scans are useful diagnostic techniques.
- Hearing tests: Hearing difficulties are frequently associated with balance issues.
- Posturography test: When wearing a safety harness and attempting to maintain balance on a moving platform, a posturography test is conducted to determine the primary components of your balance system that you rely on.
- Electronystagmography and videonystagmography: These both tests that analyze eye movements, which are integral to vestibular function and balance. Electronystagmography utilizes electrodes to record eye movements, while videonystagmography employs small cameras to capture eye movements.
- Rotary chair test: During the examination, patient will be seated in a computer-controlled chair that moves gradually in a circular motion, while the eye movements are analyzed.
- Dix-Hallpike maneuver: The healthcare provider will carefully adjust the head into several positions while watching the movements of the eyes to check for any incorrect sense of motion or spinning.
- Vestibular evoked myogenic potentials test: The neck, forehead, and under-eye sensor pads are used to track minute changes in muscle contractions in reaction to noises.
- Blood pressure and heart rate tests: To evaluate potential significant drops in blood pressure, the blood pressure may be checked while sitting and then after standing for two to three minutes. Additionally, the heart rate might be checked while standing to assist in determining if a heart condition is contributing to the symptoms.
Treatment
The treatment for the balance problems will depend on the underlying cause. The treatment plan may include the following:
- Balance retraining exercises (vestibular rehabilitation): Balance retraining and exercises customized to each person are created by therapists who specialize in balance problems. Through therapy, one can learn to continue physical activity while compensating for imbalance and adapting to decreased balance. The therapist might advise using a balance aid, like a cane, to prevent falls and provide advice on lowering fall risks in one’s home.
- Positioning procedures: A therapist might carry out a process known as canalith repositioning on those with BPPV. With this method, particles from the inner ear is removed and moved to another part of the ear. The process entails adjusting the position of your head through various maneuvers.
- Lifestyle and diet changes: Healthcare providers frequently suggest dietary adjustments to patients with Meniere’s illness or migraines to reduce symptoms. This may entail consuming less salt and avoiding foods that cause symptoms, such as coffee and alcohol. Compression stockings or increased fluid intake may be required in cases of postural hypotension.
- Medications: Healthcare providers may prescribe medications to treat vomiting and dizziness if a patient has severe vertigo that lasts for hours or days.
- Surgery: The medical team treating a person with Meniere’s disease or an acoustic neuroma might suggest surgery. Stereotactic radiosurgery may be an option for some acoustic neuroma patients. Through this method, the tumor is precisely targeted with radiation without the need for an incision.
