Three semicircular canals and two structures known as the maculae form the vestibular system in both of the human inner ears.
In addition, there is a balance center in the brain known as the vestibular nuclei. Information from the eyes, the spinal cord, and the cerebellum also converges here. The brain uses this information to determine our position in space. This allows us to stand, walk, and run. We are able to turn and rotate our head and body in space.
Medical professionals classify sensations of dizziness into:
- Rotational vertigo: Patients perceive themselves or the world around them as moving in a circular motion.
- Wobbly dizziness: The ground beneath your feet seems to tilt alternately to the right and left.
- Vertical vertigo: The surroundings appear to move up and down.
- Falling vertigo: You feel as though you might fall at any moment.
- Dizziness with lightheadedness: This sensation of staggering often lasts longer.
- Persistent or chronic vertigo: Your sense of balance is impaired for an extended period or permanently.
There are also certain situations that trigger dizziness:
- Height-induced vertigo: You feel anxious at higher altitudes.
- Motion sickness: In addition to dizziness, you experience severe nausea, for example.
In both of these cases, the brain cannot process the stimuli quickly enough and signals danger as a precaution.
However, these balance disturbances are harmless. The same applies to the sensation of dizziness after standing up quickly from a squatting position, after riding a carousel, or after rapid body turns while dancing.
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The causes of balance disorders vary widely:
You may feel dizzy (vertigo) if you stand up too quickly in the morning. This is usually caused by low blood pressure.
Rotational dizziness as positional vertigo: Otoliths become dislodged and change their position in the ear. Episodes of dizziness occur when you move your head and/or torso. The vestibular nerve has become inflamed. This is caused by herpes viruses.
Bilateral vestibulopathy: The vestibular system in both inner ears is impaired. Walking is difficult, and the condition is particularly severe in the dark. You may experience rotational and/or unsteady dizziness. The cause of this condition is unknown.
Meniere’s disease: Sudden episodes of vertigo may be accompanied by tinnitus and hearing loss. This condition involves the accumulation of excess fluid in the inner ear. Researchers do not yet know why this occurs.
Labyrinthitis: The inner ear is severely inflamed. In classic middle ear infections, dizziness is a warning sign.
Vestibular migraine: In addition to dizziness, it often presents with other signs of migraine, but it can also occur without a headache. Chronic dizziness is usually due to psychological causes. Alternatively, it can develop as a permanent condition following a stroke, for example. Dizziness can result from strabismus and other eye conditions. In addition, calcified or altered blood vessels or a stroke are possible causes of balance disorders.
Dizziness is always a warning sign from the brain that something is literally out of balance. If you are ill, if the dizziness occurs frequently, or if the cause is unclear, you should see a doctor. When doing so, describe your symptoms as precisely as possible and note the sequence in which they occur. In addition to clear-cut cases, atypical presentations also occur frequently.
For example, dizziness and nausea often occur together, as do dizziness and headaches, though not necessarily.
The following symptoms may also occur:
- Vision problems
- High or low blood sugar
- High or low blood pressure
- Shortness of breath (including during panic attacks)
- brief fainting spells and
- Pain
Sometimes several symptoms occur at once, and other times they occur one after another. The more your doctor knows, the better they can make an accurate diagnosis.
First, you should inform your primary care physician about the problem. If necessary, they will refer you to various specialists, such as:
Some hospitals have a vertigo clinic that is open in the evenings or on weekends and serves as the first point of contact in acute cases.
Benign paroxysmal positional vertigo and bilateral inner ear disorders improve or resolve with specific body and head movements. For example, the otoliths return to their original location, where they break down. Vertigo migraines and inflammation can generally be treated with medication. Cortisone helps with vertigo attacks caused by herpes viruses. However, treatment takes some time. For migraines, systematic long-term treatment is recommended.
Patients with Meniere’s disease are also prescribed medication. Overall, physical therapy exercises and medication help with many types of dizziness. For circulatory disorders, exercise is recommended, and the patient is also prescribed medication. For episodes of dizziness and balance disorders with an unknown cause, patients must try different medications and exercise regimens over several weeks.
Psychogenic vertigo, which is usually caused by anxiety (phobic vertigo), is best treated through trusting conversations and psychotherapy.
What are balance disorders?
Balance disorders are conditions in which the coordination between the vestibular system, eyes, brain, and nervous system is impaired. Typical symptoms include dizziness, unsteadiness, difficulty walking, or a disturbed sense of balance. Dizziness and balance disorders often occur together and can significantly impair quality of life.
What are the possible causes of balance disorders?
The causes of balance disorders are varied. Often, there is a disorder of the vestibular system or a disease of the inner ear. Meniere’s disease, positional vertigo, circulatory disorders, migraines, neurological disorders, tumors, strokes, or certain medications can also trigger dizziness. Other possible causes include low blood pressure, motion sickness, or age-related changes in the vestibular system.
What are the symptoms of balance disorders?
Symptoms of balance disorders include rotational vertigo, unsteadiness, a sensation of dizziness, episodes of vertigo, and difficulty walking. Many people affected also suffer from nausea, vomiting, visual disturbances, or a combination of dizziness and nausea. If the vestibular system is affected, the symptoms can be particularly severe and cause long-term impairment of balance.
How are balance disorders diagnosed and treated?
Diagnosis and treatment begin with a detailed medical history and physical examination. Depending on the suspected cause, ENT, neurological, or imaging tests may be performed. Treatment for balance disorders depends on the underlying cause and may include medication, balance exercises, physical therapy, or specific treatments for dizziness. In some cases, symptoms can also be alleviated by discontinuing certain medications.
Can balance disorders be prevented?
It is not always possible to completely prevent balance disorders. However, regular exercise, balance exercises, and treating existing medical conditions can help. Older adults, in particular, benefit from training their coordination and sense of balance. Anyone who repeatedly experiences dizziness, episodes of dizziness, or a balance disorder should consult a doctor early on to identify possible causes and risk factors.
