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What do you know about balance disorders?

Balance disorders are conditions that cause dizziness and a feeling of unsteadiness. A feeling of spinning, floating or moving about might occur when you are standing, sitting or lying down. When walking, you might suddenly feel as if you are tipping over or feel unsteady on your feet.

These can be very troublesome sensations. If the feeling happens often, it could be a sign of a balance disorder. Problems associated with balance are among the most common reasons for older people seeking doctor’s help.

Having good balance means being able to control and maintain your body’s position, whether you are moving or remaining still. An intact sense of balance helps you: 1) walk without staggering; 2) get up from a chair without falling; 3) climb stairs without tripping and 4) bend over without falling.

For a human being to present a normal balance, many body systems are involved – the muscles, bones, joints, vision, the balance organ in the inner ear, nerves, heart and blood vessels all must work normally.

When these systems aren’t functioning well, one can experience a problem related with balance. Many medical conditions can cause issues related with balance, however, most balance problems are caused by the vestibular system, an organ situated in the inner ear.

Signs and symptoms of balance disorders include sense of motion or spinning (vertigo), feeling of faintness (presyncope), loss of balance (disequilibrium) and dizziness.

One of the most common types of balance disorders is Benign Paroxysmal Positional Vertigo. This condition occurs with head movements. One experiences a brief, intense feeling of vertigo, such as on rolling over to the left or right sides when getting out of bed, or when looking for an object on a higher or lower shelf.

Benign Paroxysmal Positional Vertigo occurs when calcium crystals, which are situated in the inner ear helping to control the balance, become dislodged from their normal position and move elsewhere in the inner ear. This is more likely to occur in adults aged 60 and older, but can also occur in younger people. There are other conditions that also cause vertigo, such as Meniere’s Disease, Migraine, Acoustic Neuroma, Vestibular Neuritis, among many others.

The feeling of faintness or presyncope can be associated with Orthostatic Hypotension or Cardiovascular Disease. In Orthostatic or Postural Hypotension, standing or sitting up too quickly can cause some people to experience a significant drop in their blood pressure, resulting in presyncope. On the other hand, abnormal heart rhythm, narrowed or blocked blood vessels, a thickened heart muscle or a decrease in blood volume can reduce blood flow and cause presyncope.

Disequilibrium can result from: vestibular problems (abnormalities in the inner ear); nerve damage to the legs (peripheral neuropathy); joint, muscle or vision problems; medications or certain neurologic conditions (cervical spondylosis or Parkinson’s disease).

Finally, a sense of dizziness or light-headedness can result from: inner ear problems (abnormalities of the vestibular system can lead to a sensation of floating or other false sensation of motion); psychiatric disorders (like depression or anxiety); abnormally rapid breathing (hyperventilation) and medications.

Diagnosis of a balance disorder is difficult. To find out the origin of a balance problem one must consult an otolaryngologist (ENT Specialist), who is a physician and surgeon specialising in diseases and disorders of the ear, nose, throat and neck. The otolaryngologist may ask you to undergo a hearing test, blood tests, or ultrasound exam of the head and brain.

To help you decide whether medical help should be sought for a dizzy spell, you should ask yourself the following questions:

1) Do I feel unsteady?
2) Do I feel as if the room is spinning around me?
3) Do I feel as if I’m moving when I know I’m sitting or standing still?
4) Do I lose my balance and fall?
5) Do I feel as if I’m falling?
6) Do I feel light-headed or as if I might faint?
7) Do I have blurred vision?
8) Do I ever feel disoriented,losing my sense of time or location?

If the answer is “yes” to any of these questions, see your doctor.

This article has been supplied by the ENT team at the Hospital Particular do Algarve Group.