Balance Problems

Diagnosing balance disorders involves a thorough evaluation of your medical history, physical health, and neurological function:

Medical and neurological examination: Your doctor assesses posture, gait, and coordination to identify potential causes of imbalance.
Hearing tests: Hearing difficulties are often associated with inner ear-related balance problems.
Posturography test: Standing on a moving platform while wearing a safety harness helps determine which parts of your balance system you rely on most.
Electronystagmography (ENG) and videonystagmography (VNG): Eye movements are recorded to evaluate vestibular function. ENG uses electrodes, while VNG uses small cameras.
Rotary chair test: Eye movements are analyzed while you sit in a computer-controlled chair that moves in a circular motion.
Dix-Hallpike maneuver: Your head is moved into different positions while eye movements are observed to detect vertigo caused by positional changes.
Vestibular evoked myogenic potentials (VEMP) test: Sensors measure muscle responses in the neck, forehead, and under the eyes to sound stimulation.
Imaging tests: MRI or CT scans can identify structural causes of balance problems.
Blood pressure and heart rate tests: Measurements are taken while sitting and standing to identify postural hypotension or heart-related causes of dizziness.

Treatment depends on the underlying cause of imbalance and aims to reduce symptoms and prevent falls:

Balance retraining exercises (vestibular rehabilitation): Customized exercises help you compensate for imbalance, adapt to reduced balance, and maintain physical activity. Therapists may recommend balance aids, such as a cane, and suggest home safety modifications.
Positioning procedures: For benign paroxysmal positional vertigo (BPPV), canalith repositioning maneuvers help move displaced inner ear particles to a less sensitive location.
Diet and lifestyle changes: For conditions like Meniere’s disease or migraine-associated vertigo, limiting salt, caffeine, alcohol, and other dietary triggers may reduce symptoms. Postural hypotension may be managed with increased fluid intake or compression stockings.
Medications: Severe vertigo and nausea may be treated with medications that reduce dizziness and vomiting.
Surgery: In cases of Meniere’s disease or acoustic neuroma, surgical options, including stereotactic radiosurgery, may be considered. Radiosurgery delivers targeted radiation to the tumor without the need for an incision.

Timely diagnosis and tailored treatment plans help improve balance, reduce dizziness, and enhance quality of life.

Overview