Balance Disorders

Balance Disorders

A balance disorder is a complex condition that causes unsteadiness and dizziness, and sensations of spinning, moving or floating. Part of the inner ear known as the labyrinth interacts with other body systems, including those of the eyes, bones and joints, to maintain balance. The part of the inner ear that is involved with balance is called the vestibular system, and balance disorders associated with the ear are referred to as vestibular disorders. Problems within the ear, brain or nervous system cause balance problems that affect more than two million people each year.

Symptoms of Balance Disorders

Symptoms of a balance disorders may come and go, or be constant. They may cause anxiety or panic when they occur, and may include:

  • Dizziness
  • Vertigo
  • Lightheadedness
  • Motion sickness
  • Blurry vision
  • Disorientation
  • Nausea

Vomiting, diarrhea, and increased heart rate or blood pressure may also accompany the symptoms listed above.

Causes of Balance Disorders

In many cases, a specific cause for the symptoms of a balance disorder cannot be determined. However, a balance disorder is often the result of another medical condition, which may be minor or severe. These medical conditions usually affect the visual, vestibular or general sensory systems, or the brain. Balance disorders may also be caused by:

  • Certain medications
  • Ear infections
  • Head injury
  • Aging
  • Blood-circulation disorders affecting the inner ear or brain

Diagnosis of Balance Disorders

Because dizziness and vertigo are symptoms of many conditions, it can be hard to pinpoint a balance disorder's exact cause. Depending on a patient's symptoms, a series of audiologic, vestibular and movement tests may be performed in order to reach a diagnosis. Those tests may include:

  • Hearing test
  • Blood test
  • MRI scan
  • Posturography, which tests balance
  • Electronystagmogram, which measures eye movement and muscle control
  • Cardiology Consultation for evaluation of the heart for potential arrhythmias, blood pressure issues, etc.
  • Neurology Consultation for possible central (brain related), cervical (neck position related), migrainous vertigo

Types of Balance Disorders

Identifying the underlying cause and the type of balance disorder are both important for successful treatment. When a cause for the balance disorder is determined, a specific treatment plan can be created. Balance disorders are commonly characterized by their symptoms or causes. There are several types of common balance disorders.

Benign Paroxysmal Positional Vertigo

Also known as BPPV, benign paroxysmal positional vertigo is a condition that causes feelings of vertigo after specific position changes of the head. BPPV may be caused by an infection or inflammation of the ear that causes the calcium particles to shift, resulting in balance problems and vertigo. Patients who suffer from BPPV may have brief periods of vertigo that come and go.


Labyrinthitis result in acute onset of hearing loss, dizziness and a loss of balance. It is usually caused by an infection or inflammation of the inner ear that is the result of an upper-respiratory infection and is thought to be viral in origin, so antibiotics are often of little use.  In most cases symptoms resolve significantly within the first week, and more completely over the subsequent six weeks.  Early evaluation and treatment of the sudden hearing loss is important in order to achieve the best chance of recovering some hearing, which unfortunately is not always possible.

Meniere's Disease

Meniere's disease symptoms, which are caused by an imbalance of fluid in the inner ear, include vertigo, hearing loss and ringing in the ears. Symptoms of Meniere's disease may vary in both frequency and intensity. Some patients experience many symptoms within a short period of time, followed by months or years without them.

Vestibular Neuronitis

Vestibular neuronitis is the swelling of the vestibular nerve, which is responsible for sending balance signals from the inner ear to the brain. This condition usually causes vertigo. Vestibular neuronitis often follows a cold or other viral infection, although by the time symptoms arise, the viral infection is usually long gone.

Perilymph Fistula

Perilymph fistula is the leakage, caused by a physical injury or exertion, of inner-ear fluid. The symptoms of perilymph fistula may include dizziness, vertigo, nausea and vomiting. Some patients experience ringing or fullness in the ears, and many notice hearing loss which is often permanent.  Symptoms may get worse when there is a change in altitude or air pressure.

Treatment for Balance Disorders

Treatment for a balance disorder depends on its cause, and treating the cause often eliminates the balance problem. The following treatments may also help to relieve symptoms:

  • Balance-training exercises
  • Lifestyle changes, such as limiting alcohol and caffeine
  • Oral and trans-tympanic steroids
  • Anti-vertigo and anti-nausea medications

A vestibular rehabilitation therapist can also assist patients by developing individualized treatment plans that combine head, body and eye exercises designed to decrease dizziness and nausea. Surgery on the vestibular organs may be recommended for patients whose symptoms cannot be controlled by more conservative methods.