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FLEX AUDIOLOGY

Balance

Your Dizziness And Balance Resource

Dizziness, vertigo, and balance disorders are common conditions affecting about 90 million Americans during their lifetime. For some, these are simply an everyday inconvenience, but more than one-half of the accidental deaths in the elderly and over 300,000 hip fractures in individuals over age 65 are from balance-related falls.

Vertigo and unsteadiness on their feet top the list of complaints by patients over 70 years of age. Keeping your balance requires multi-sensory coordination of your vision, your vestibular system, and your proprioceptive system (sensory input from our muscles and joints). Vertigo and balance disorders come from any disturbance or malfunction in one or a combination of these systems.
Dr. Person conducting a balance disorder test in the clinic

Your Ears And Balance

In addition to processing and transmitting sound to your brain, your ears play a critical role in helping you stay steady on your feet. The vestibular system is located in the semi-circular canals of your inner ear, which function similar to the bubble in a carpenter’s level in order to help you maintain your balance.

The fluid inside the semi-circular canals interacts with hairlike cells along the walls of the canals, detecting up, down, and side-to-side movements. Whenever the hairlike cells detect movement and changes to the position of your head, they transmit a signal to the brain, which directs other parts of the body to react in order to keep you upright.

Disorders of the vestibular system cause it to overreact to minor movements or even when you are completely still, causing serious problems like vertigo, imbalance, nausea, and vomiting. Vestibular system damage is not limited to the elderly and can affect people of any age due to disease, syndromes, toxins, or trauma.

The Symptoms Of Balance Disorder

The initial symptom of a balance disorder is a sense of dizziness, vertigo, or motion intolerance that often follows rapid head movements or turning too quickly, which you might experience briefly or for several hours at a time. The second sign of a balance disorder is a persistent feeling of unsteadiness or imbalance that makes it difficult to sit up in bed, get up from a chair, or walk.

Vestibular migraines are another symptom associated with valance disorders, which affects one in every four females and one in every six males and is classified as a strongly hereditary neurological disorder. Rather than causing a headache, these migraines cause dizziness, vertigo, nausea, eye pain, and changes in vision.

Types Of Balance Disorders

Deterioration of the inner ear structures as you age, or due to some other cause, produces hearing loss but can also lead to a balance disorder. However, damage to your inner ear structures can also derive from various illnesses or injuries, including:

Labyrinthitis or Vestibular Neuronitis

These conditions result from an inner ear infection that causes inflammation in the labyrinth structure of the inner ear. The inflammation can cause tinnitus and/or hearing loss, which is a symptom of labyrinthitis but not a symptom of vestibular neuronitis.

Meniere’s Disease

An increased pressure within the labyrinth structure, which typically affects only one ear (though it can affect both). Because of the predictable buildup of pressure before an episode, medications are often prescribed to help manage the condition. Meniere’s disease is often temporary and goes away naturally after a few years.

Perilymph Fistula

When fluid from the inner ear leaks into the middle ear, the condition is known as perilymph fistula. This condition is common in birth defects, is associated with head injuries or surgeries, follows a severe ear infection, or can be an after-effect of scuba diving.

Benign Paroxysmal Positional Vertigo (BPPV)

This occurs when calcium carbonate, otoconia, migrates into one of the semi-circular canals from the utricle, affecting the normal movement of fluid inside the semi-circular canal and giving false signals to the brain regarding balance. It often follows a head injury or head surgery.

Mal de Debarquement Syndrome (MdDS) or Disembarkment Syndrome
This includes a sensation of prolonged movement like the rocking of a boat or motion of a treadmill even after you have gotten off of them.

Vestibular Testing

Identifying the source of your vertigo, dizziness, or balance challenges involves a full vestibular examination and audiological evaluation (if not done before the appointment). A full vestibular examination includes a series of inner ear, eye movement, and neurological connection evaluations to identify the cause of your vertigo or dizziness.

In order to provide the most accurate results from vestibular testing, there are specific actions you need to take or avoid before your appointment, including:

Eat only a light meal to reduce nausea that might occur during testing

Avoid applying eye make-up, which can affect eye movement tests

Stop taking anti-vertigo, sleeping, or pain medication

Avoid drinking alcoholic beverages for 48 prior to testing

How To Treat Dizziness and Balance

The cause and severity of each condition after diagnosis determines the treatment options applied to correcting, rehabilitating, or managing symptoms.

Medication is used to treat inflammation-causing infections like labyrinthitis and vestibular neuronitis and to help manage the pressure related to Meniere’s disease. Vestibular Rehabilitation Therapy (VRT) is among our most common treatment options for dizziness, vertigo, and balance challenges.

VRT involves the use of a series of exercises designed to help desensitize the balance system, especially as it adjusts to certain movements. Its purpose is to allow patients to move around freely without triggering dizziness or vertigo, protecting them from becoming unsteady on their feet and preventing falls.

Among the therapeutic approaches to treat BPPV is Canalith Repositioning, which has produced measurable results for the last 25 years. The treatment takes only minutes and is successful in treating 95% of patients, usually in less than 3-4 treatments. These maneuvers help to remove the otoconia from the semicircular canal and bring them back to the utricle where it belongs.

Frequently Asked Questions About Vestibular Testing

#1 – How long does the vestibular test take?

The testing needed to analyze your vestibular system can last up to 2 hours.

#2 – Does the vestibular test hurt at all?

No, you should experience no pain during the test, but you may feel a little more dizzy than usual, as your doctor will need to examine the extent of your problem.

#3 – What happens after the test?

Following a vestibular test, in most cases, your doctor of audiology will provide a physician with the results, and they will be able to offer further treatment suggestions.

#4 – Can a vestibular disorder be cured?

Treatment varies based on each individual’s needs. Your doctor will determine which treatment plan is best for you. Treatment can include physical therapy, vestibular rehabilitation, canalith repositioning maneuvers, or referral to an Ear, Nose and Throat specialists

Ask Dr. Person

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