An individual's sense of balance well-being occurs when the brain integrates normal signals from the ears, eyes and the muscles in the legs. When children or adults have an issue with any of these organs, balance disorders can arise.
Your Ears and Balance
The most common source of balance disorders is an abnormality of the inner ear. There are two parts to the inner ear: the organ of hearing, the cochlea and the organ of balance, the labyrinth (comprised of the semicircular canals and utricle). The labyrinth tells a person their position in space. If a person turns around or goes up, that individual is aware of the movement because the inner ear is being stimulated. When the inner ear does not work right, there is a false sensation of moving. This is the definition of the word “vertigo,” the room spinning, the floor rocking. While vertigo is one of the most common complaints of patients with inner ear balance disorders, other common complaints include feeling “woozy,” “light headed,” “drunk,” “off balance,” “difficulty focusing,” or “spacey.”
Balance disorders that arise from the inner ear are often associated with hearing loss, ear fullness or a noise in the ear (tinnitus). In order to evaluate an inner ear balance disorder hearing tests and balance tests are often necessary. Common disorders of the inner ear that cause imbalance include Meniere ’s disease and vestibular neuronitis.
Your Eyes and Balance
The eyes are also powerfully connected to the inner ear. When the inner ear is not working right, there is often an abnormal eye movement that the physician can observe called nystagmus. Conversely, many patients are sensitive to eye stress, such as scanning a computer or being in a room with surrounding motion and excessive visual stimulation, like walking down the isle of supermarket. Think of the person standing on the top of a tall building who feels like she is falling. Or when a person is sitting in a car or a train and an adjacent vehicle starts to go forward and he feels like he is going backwards. That is the eye miscommunicating with the rest of the balance system. Accordingly, poor or distorted vision often leads to imbalance.
Your Brain and Balance
All signals (from ears and eyes) eventually come to the brain. Yet, the brain is not commonly the cause of imbalance. Still, conditions like migraine headache, a brain phenomenon, can be associated with dizziness or vertigo. There are rare seizure disorders associated with vertigo. An over accumulation of fluid surrounding the brain, hydrocephalus, can cause imbalance and difficultly walking. Brain disorders are often diagnosed with the help of a neurologist and the use of MRI (Magnetic Resonance Imaging) scans.
Age and Balance
With aging there is a decrease in function of all of the critical areas associated with balance, such as ears, eyes and leg muscles. As the brain ages there is less plasticity (the ability to rebound from injury) and less ability to integrate complex signals from multiple organ systems. Common issues associated with age that may contribute to balance disorders include:
- Just as hearing decreases with age, so too the organ of balance in the inner ear becomes less efficient with age.
- Vision decreases with age and eye diseases such as cataracts and retinal disease affect depth perception.
- The muscles in the legs weaken with age and the muscle sensors are often adversely affected by neurological disease, such as the peripheral neuropathy of diabetes.
- Orthopedic problems, such as a bad back, hips or knees will often change the way a person holds their posture, causing dizziness or imbalance.
Dizziness caused by aging is difficult to treat because many patients are impacted by a combination of multiple problems. Management based on vestibular rehabilitation therapy can be a very effective treatment strategy because it is an exercise-based therapy designed to improve function between ears, eyes and muscles and has no potential side effects.