Balance disorders, in which patients feel dizzy or experience a sensation of spinning movement, can be roughly divided into two main groups: disorders caused by problems with the ear and disorders caused by problems with the brain. The body's balance system, also known as the vestibular system, is quite complex, involving structures within the ear which help the body orient itself in space, input from the body and eyes, and the processing of the brain, which brings all of the information together. Balance disorders can have an array of causes and treatment options depend on the cause of the disorder and the severity of the symptoms.
Balance disorders caused by problems with the ear can include infections such as vestibular neuronitis and labyrinthitis, along with trauma to the head which damages the structures in the ear which contribute to the sense of balance. Other problems can include a perilymph fistula, in which fluid from the inner ear leaks out in the middle ear, Meniere's disease, which causes a fluid imbalance in the ears, and benign paroxysmal positional vertigo, in which changes in head position cause instability in the sense of balance. Patients can also experience bilateral vestibulopathy and superior canal dehiscence syndrome, both of which cause balance problems.
The brain can be involved in balance disorders in a number of ways. Aging can be a contributing factor, with many elderly adults experiencing difficulties with balance. Infections in the brain, degeneration caused by aging or disease, trauma to the head, structural deformities in the brain, neurological conditions, and cancers in the brain can all cause balance disorders. Balance disorders can also be related to autoimmune conditions.
Changes in the available sensory input from the body can also contribute to balance problems. Loss of a limb can disorient the brain, as can loss of an eye or severe damage to the vision. This also works in reverse: someone with newly correct vision may have trouble balancing for several days while he or she gets used to seeing with glasses. Muscle weakness may be involved in balance disorders as well.
People who experience vertigo, dizziness, or general difficulty balancing can be treated by a doctor who can determine the cause of the balance disorder and develop treatment options for the patient. When a balance disorder is connected with an ongoing medical problem, addressing the underlying cause can usually resolve the balance disorder. In some cases, it may not be possible to cure the patient, but a doctor can provide coping techniques which will reduce the risk of falls and keep the patient more comfortable.
