Wednesday, February 28, 2001

Spinning, unsteadiness and imbalance problems with dizziness

Feelings of dizziness or unsteadiness are a common health complaint.

About 42 percent of the population will complain to their doctor or audiologist at least once in their lifetime. The frequency of balance disorders increases with age: for those over 70 years of age, balance disorders are one of the most common reasons for seeking medical help.

Dizziness may be related to ear and hearing problems because the balance center- the vestibular system- is connected directly to the inner ear. The vestibular and inner ear also share the same nerve leading to the brain.

Common complaints include a feeling that the room is spinning, unsteadiness, fainting or feeling you might faint. These attacks may occur suddenly or when changing position (such as getting out of bed or rolling over in bed). Nausea with or without vomiting may accompany the attack.

The sensations may last just a few minutes or may be severe and long term. The person may also suffer headaches, muscular aches in the neck and back, and fatigue.

Types of dizziness

The term vertigo refers to balance disorders attributed specifically to the vestibular system. The person usually complains of feelings of spinning or turning rather than a more general sense of unsteadiness. Vertigo can be caused by viral infections, certain medications, head trauma, ear infections and, rarely, tumors.

The dysequilibrium refers to more generalized problems of unsteadiness. These complaints are usually not related to the inner ear, but to more general problems such as high blood pressure, hyperventilation or a disruption in blood circulation.

Because there are so many possible causes, identifying the cause of a balance disorder is a challenging task. The first step is a medical examination, including a complete history.

Specialized tests may include audiologic testing and vestibular testing (electronystagmography, or ENG). Neurologic and X-ray studies may be done, as well as balance testing (posturography).

Treatment

If the examination results indicate a specific cause, treatment can be directed at the cause of the balance disorder. In other cases, medication or a chage in diet may be used to control the symptoms.

A vestibular rehabilitation program may be recommended. This is a series of exercises designed to teach the brain to compensate for the loss of balance function. The brain can also be trained to rely on other modalities, such as vision and support, to aid in balance.