Dizziness and Imbalance

What is Balance Awareness Week all about?

Balance Awareness Week is a global effort to raise awareness of vestibular (inner ear balance) disorders which cause dizziness and balance problems. The aim is to improve the care and treatment of those who suffer from balance disorders, and to help sufferers and those who support them gain a better understanding of these conditions and the negative effect they have on someone’s quality of life.

40% of people over 40 suffer symptoms of dizziness and imbalance at some time. While some of these conditions are incurable, many are easily treatable. Faster and more accurate diagnosis, along with effective treatment or management, can greatly improve patients’ quality of life. Read on to hear about some common, and some not-so-common, balance disorders. We want to make “vestibular” a word that everyone can easily understand, so that people who lose their balance can be diagnosed more quickly, treated more effectively, and gain the support they need from those around them.

If you have any questions or comments, please do get in touch. We look forward to hearing from you!

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of dizziness. It is estimated to affect roughly 10% of all people at some time in their lives and the chance of occurrence increases with age. It can be very debilitating but is rarely associated with serious disease.

Symptoms are usually rotational vertigo (sensation of movement) like getting off a roundabout lasting anywhere from 5 seconds to 2 minutes.

The classic provoking movements to induce BPPV include lying flat, sitting up from lying flat, turning over in bed, looking up, or bending down.

BPPV is caused when loose chalk crystals get into the wrong part of the inner ear. Lying flat can cause some of these crystals to fall into one of the semi-circular canals; the parts of the ear responsible for sensing rotation. Movement in the plane of the affected canal causes the crystals to move along the canal, stimulating it and giving the sensation of rotation.

Diagnosis can be made using the Dix-Hallpike Positional Test and treatment is usually through a Particle Repositioning Manoeuvre which provides full relief of symptoms after just one course of treatment in 80% of cases.

Vestibular neuritis or labyrinthitis

Vestibular neuritis is an inner ear disorder that involves swelling of the balance portion of the inner ear nerve, and may cause a person to experience symptoms such as sudden, severe vertigo, unsteadiness, nausea and vomiting. Labyrinthitis involves swelling of both the balance and hearing portions of the inner ear nerve so additional symptoms may include tinnitus and/or hearing loss.

Generally, the most severe symptoms of vertigo and unsteadiness only last a couple of days, although they can significantly affect a person’s ability to carry out everyday tasks. Most people make a slow, but full recovery over the next few weeks. However, some can experience dizziness and balance problems that can last for several months and may need a course of balance rehabilitation to help them recover fully.

For most people, vestibular neuritis is a one-time experience. But for some the condition can re-occur and regular management is required.

Meniere’s disease

Meniere’s disease is a disorder of the inner ear that can lead to vertigo and hearing loss. It can occur at any age, but it usually starts between young and middle-aged adulthood.

Signs and symptoms of Meniere’s disease include recurring episodes of sudden vertigo usually lasting 20 minutes to several hours often accompanied by nausea and vomiting, as well as roaring tinnitus, temporary hearing loss and a feeling of fullness or pressure in the affected ear. With repeated attacks the hearing loss and tinnitus can become permanent, and a general unsteadiness can develop.

The cause of Meniere’s disease is unknown but the symptoms appear to be the result of a build-up of excess fluid in the inner ear, but it isn’t clear what causes that to happen. It is considered a chronic condition, but various treatments can help relieve symptoms and minimise the long-term impact on your life.

Vestibular migraine

Vestibular migraines, like other migraine syndromes, often run in families. It is thought that women tend to suffer more from the condition than men, and symptoms may get worse around the time of changes in hormone levels, such as menstruation, puberty, or menopause. Some sufferers can be susceptible to particular migraine triggers in their lifestyle; such as altered sleep patterns, stress, and certain foods, such as, chocolate, cheese, caffeine, or red wine.

Vestibular migraines can involve combinations of the following symptoms:

Migraine headache symptoms, such as:

• Severe, throbbing headache, usually on one side of the head
• Nausea and vomiting
• Sensitivity to light, smell and sound

Vestibular symptoms, such as:

• Vertigo (dizziness), usually lasting minutes to hours, but sometimes days
• Unsteadiness and loss of balance
• Sensitivity to motion

Occasionally, there can be associated hearing symptoms, such as:

• Tinnitus
• A feeling of fullness or pressure in the ears

Treatment for vestibular migraine is similar to that for other migraine syndromes. People with vestibular migraines can sometimes reduce the number and intensity of episodes by maintaining a regular sleep and meal schedule, avoiding triggers, exercising regularly and managing stress. Balance rehabilitation can be helpful for those suffering from general unsteadiness.

What to do if you are affected

It is really important for people with balance disorders to be aware that support is available.

For more details and a free information pack about dizziness and balance disorders, you can contact the Meniere’s Society on 01306 876883 or visit www.menieres.org.uk.

If you think you have a balance disorder and need support, please contact us to make an appointment. We can help.