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Vestibular Balance Disorder

What is vestibular balance disorder?

Dizziness and vertigo are symptoms of a vestibular balance disorder. Balance disorders can strike at any age, but are most common as people age.

Your ear is a complex system of bone and cartilage. Within it is a network of canals. These are called semicircular canals. There are also fluid-filled pouches. These are called the otolithic organs. These structures contribute to your sense of balance. Part of this system includes the cochlea. This is a spiral structure that also helps you hear. All of these delicate pieces make up the vestibular system.

Certain things can affect the signals from any of the parts of the vestibular system causing symptoms.

What causes vestibular balance disorders?

Common causes of vestibular balance disorders include:

  • Medications
  • Infections
  • Inner ear problems, such as poor circulation in the ear
  • Problems rooted in your brain, such as traumatic brain injury

What are the symptoms of vestibular balance disorders?

The symptoms of a vestibular balance disorder include:

  • Dizziness
  • Feeling off-balance
  • Feeling as if you are floating or as if the world is spinning
  • Blurred vision
  • Disorientation
  • Falling or stumbling

Less common symptoms include:

  • Nausea
  • Diarrhea
  • Vomiting
  • Anxiety
  • Fear
  • Changes in your heart's rhythm

How is vestibular balance disorder diagnosed?

You may need to work with an ear, nose, and throat specialist. This type of doctor is called an otolaryngologist or ENT. Dizziness and lightheadedness can be caused by many conditions. Part of the diagnosis could involve ruling out other causes. The diagnosis may involve the following:

  • A look at your personal medical history
  • Hearing exam
  • Vision exam
  • Blood tests
  • Imaging tests of the head and brain
  • Clinical tests of balance
  • A look at your posture and movement, using a structured, exam called a posturography


How is vestibular balance disorder treated?

Treatment will depend on the cause of your balance disorder and may include:

  • Treating any underlying causes. Antibiotics or antifungal treatments may be needed. These can treat ear infections that are causing your balance disorder.
  • Changes in lifestyle. Some symptoms may be eased by changes in diet and activity. This includes quitting smoking or avoiding nicotine.
  • Epley maneuver (Canalith repositioning maneuvers). These are a specialized series of movements of your head and chest. The goal is to reposition the otoliths into a position in your inner ear where they don’t trigger symptoms.
  • Surgery. This is used when medications and other therapies are unable to control your symptoms. The procedure depends on the underlying cause of the disorder. The goal is to stabilize and repair inner ear function.
  • Rehabilitation. If you struggle with vestibular balance disorders, you may need vestibular rehabilitation or balance retraining therapy. This helps you move through your day safely. A rehabilitation specialist will help you learn how to cope with dizziness in your daily life. You may need to learn better safety strategies and make adjustments for
    • Going up and down stairs
    • Driving (ask your doctor when it will be safe for you to drive)
    • Walking and exercising
    • Using the bathroom
    • Organizing your home to make it safer, such as tightening handrails
    • Changing your shoes or clothing, such as wearing low heeled shoe
    • Changing your daily habits, such as planning your day so that you won't be walking in the dark
    • Learning how to use a cane or walker 

What are the complications of vestibular balance disorder?

Possible complications include:

  • Injury from falling 
  • Reduced quality of life
  • Discomfort

Living with vestibular balance disorder

The symptoms of vestibular balance disorder can interfere with regular daily activities and your ability to drive, work, or enjoy recreation activities. This can cause symptoms of depression and frustration. Counseling can help you learn to cope with the disorder and life style impacts.

When should I call my health care provider?

Feeling lightheaded or dizzy occasionally happens to most people. If these sensations are frequent and affect your quality of life, contact your health care provider.

Key points about vestibular balance disorders

  • Vestibular balance disorders can affect orientation and balance.
  • Treatment depends on the underlying cause and can include medications, rehabilitation, and lifestyle changes. Surgery for symptoms that do not resolve with other treatments may be needed.
  • Talk to your health care provider if you have symptoms of vertigo, dizziness, or hearing changes. These can mean you have a vestibular balance disorder.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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