Balance Disorder Specialists Northern Utah Trusts

Maintaining your balance involves coordination between three of your body’s systems, including: cues from your visual system, orientation information from your vestibular system, and your proprioceptive system (sensory input from muscles and joints). Dizziness and balance disorders result from a disturbance or malfunction in one or more of these systems but are most often linked to problems with the vestibular system.

The vestibular system is located in the inner ear, detecting movement and changes to the positioning of your head and/or body, and it works similar to the bubble in a carpenter’s level. As the fluid within the three semicircular canals of the inner ear moves up, down, or side-to-side in relation to your movements, the fluid interacts with hair-like cells, which send signals to the brain regarding the positioning or orientation of your body.

Although more prevalent in the elderly as the structures of the inner ear begin to deteriorate, balance disorders can affect people of any age due to disease, syndromes, toxins, or trauma.

If you have a balance disorder, you are likely to experience some common symptoms of balance disorders related to the inner ear, which can be divided into two main categories:

Motion Intolerance

Experiencing dizziness (an overall feeling of imbalance) or vertigo (the sensation that you’re moving or your surroundings are spinning), even when you’re sitting still or reclining, can occur whenever you move your head or turn too quickly. These symptoms might come and go rapidly or continue for several hours at a time.

Imbalance or Unsteadiness

A feeling of unsteadiness when you get up from a chair, difficulty walking, or unsteadiness associated with any form of upright movement are symptoms of an inner ear balance disorder as well.

Balance disorders often take people by surprise, appearing suddenly and without apparent reason. When they occur, they can be both frightening and extremely disruptive to people’s lives.

In excess of 50% of the accidental deaths and over 300,000 hip fractures among the elderly can be linked to balance-related falls. Because of the risks to yourself and those around you, balance disorders need to be taken seriously.

The three most common causes of balance disorders include:

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) involves the breaking off of calcium carbonate, otoconia, in the utricle, which migrates into one of the semi-circular canals. The displaced otoconia interrupts the normal movement of the fluid within the semi-circular canals, leading to false signaling and the sensation of vertigo. Although BPPV is more common in older adults, it can also affect younger individuals, especially after a head injury.

Motion Sickness or Mal de Débarquement Syndrome (MdDS)

Often referred to as motion sickness, MdDS is a neurological disorder related to the signaling function of your vestibular system that causes you to continue to feel as if you are rocking, swaying, or continuing to move after exiting a car, boat, plane, or exercising on a treadmill. Confused by the false signaling, your brain overreacts to the sensation of motion, leading to dizziness, vertigo, nausea, and imbalance.

Vestibular Migraines

Most migraines are typically associated with an intense headache, but vestibular migraines are a neurological disorder that produces dizziness, vertigo, nausea, eye pain, changes to vision, and balance disorders. They are strongly hereditary, affecting 1 in 4 women and 1 in 6 men and can be a symptom of BPPV, Méniére’s disease (an increased pressure in the inner ear), and transient ischemic attack (TIA), or “mini-stroke.”

The treatment options for balance disorders depend upon the underlying cause of the condition and might include:

Canalith Repositioning

Used to treat BPPV, canalith repositioning helps remove the otoconia from the semicircular canal and return them to the utricle. Successful in treating 95% of cases, treatment takes only minutes and requires no more than 3-4 visits.

Medications

Beta-blockers, calcium channel blockers, tricyclic antidepressants, serotonin, or serotonin/norepinephrine reuptake inhibitors (SSRIs or SNRIs), topiramate, and others can be prescribed to ease the dizziness, vertigo, or motion sickness associated with MdDS as well as other medications to address the buildup of pressure related to Méniére’s disease.

Hearing Aids

For those who experience an accompanying hearing loss due to inner ear damage, hearing aids provide a dual solution for both hearing and balance issues. Studies indicate a measurable advantage in balance for those who wear hearing aids over those with a hearing loss who do not use hearing aids.

Vestibular Rehabilitation Therapy (VRT)

The most common treatment used to address balance disorders is VRT, or vestibular rehabilitation therapy, which involves manual head maneuvers and/or a progressive program of exercises designed to decrease the symptoms of vertigo, help overcome visual issues, and protect patients against falls related to imbalance.