Dizziness and Balance Basics

Senior woman riding city bike in town

Our balance system is something most of us take for granted as long as we can walk, run or move without falling. Balance is controlled through signals to the brain from your eyes, the inner ear (vestibular system) and the sensory systems of the body, such as muscles, skin and joints.

If any one of these systems fails to work properly, a dizziness or balance disorder may be the result. When your balance is weakened, you may feel unsteady, woozy, or disoriented. You may have blurred vision or experience a sensation of movement. It may seem that the room is spinning (vertigo). You may not be able to walk without staggering, or you may not even be able to get up.

Sometimes nausea, vomiting, faintness, changes in heart rate and blood pressure, fear, and anxiety accompany the dizziness and balance problems.

In some cases, dizziness and balance problems have an underlying medical cause, such as stroke or high blood pressure. It’s important to see your health care provider to determine if there is an underlying cause and find out how it can be treated. However, in many cases, dizziness and balance difficulties cannot be treated medically or surgically, and a referral to a specialist in vestibular disorders may be helpful.

What is dizziness?

According to the American Speech-Language-Hearing Association, if you experience light-headedness, a sensation of losing your balance, or a sense of feeling unsteady, you may be one of the millions of Americans who experience dizziness. Dizziness is one of the most common complaints and affects 20% to 30% of the general population. In fact, dizziness is a common reason that adults seek medical attention.

Dizziness can be associated with a variety of conditions, including:

  • Viral or bacterial infections, including ear infections
  • Foreign objects in the ear canal
  • Blood pressure changes
  • Vascular problems
  • A fistula (hole) in the inner ear
  • Ménière’s disease
  • Medicines or drugs poisonous to the ear or balance system (ototoxic medicines)
  • Multiple sclerosis
  • Visual disorders
  • Tumors, especially of the vestibular portion of the eighth cranial nerve (known as acoustic neuroma)
  • Head injury
  • Migraine
  • Benign Paroxysmal Positional Vertigo (BPPV)

What is vertigo?

Vertigo is a type of dizziness in which there is a sense of movement or spinning. Changing position, such as sitting up in bed, can make it seem worse. Nausea and vomiting may accompany the vertigo at times.

Balance testing

The equilibrium system is very complex and cannot be directly observed. To truly understand a patient’s equilibrium, a number of sophisticated tests must be performed, correlated, and compared.

Balance disorders are often accompanied by changes in hearing and/or ear function. These changes can be obvious or hardly noticeable by the patient. Comprehensive testing should include examination of your outer, middle, and inner ears. These tests include audiologic, tympanometry/immittance, and otoacoustic emission tests.

A number of complex pathways control equilibrium. An evaluation should include sophisticated measures of these pathways and the central nervous system. These tests are:

  • Auditory Brainstem Response (ABR)
  • Electro-oculography
  • Video Head Impulse Test (vHIT)
  • Rotary Chair
  • Sensory Organization Performance (SOP)
  • Electrocochleography (ECOG)
  • Vestibular Evoked Myogenic Potential (VEMP)
  • Video/Electro-nystagmography (VNG/ENG)

When should I see an audiologist?

Dizziness and balance problems can be a sign of a medical issue that needs immediate attention, so see your primary care provider to determine if this might be the case. Your provider then may refer you to an audiologist who specializes in dizziness and balance problems for further evaluation.  You don’t have to live with dizziness or vertigo.

Associated Audiologists offers a comprehensive dizziness and balance clinic. The clinic uses state-of-the-art technology to evaluate individuals suffering from dizziness, balance problems, and/or who have a history of falls related to inner-ear disorders. The program is staffed by Danielle Dorner, Au.D., Vestibular Audiologist, who sees patients at our Overland Park and Northland clinics.

For more information about dizziness and balance issues, download our free e-book, What to know about dizziness and imbalance.

To schedule an appointment with Dr. Dorner, call 816-442-7831.