It is a frightening experience when the ground beneath your feet slips. Dizziness and balance disorders invoke more fear than their actual disabilities. Statistics say that dizziness is the second most common complaint heard in a doctor’s office and will occur in 70% of the nation’s population at some point in their lives.
What is vertigo
Dizziness or vertigo is not a disease or a diagnosis; it is only a symptom which may be due to an umpteen number of causes. The symptoms may be mild or severe enough to interfere with day-to-day activities.
One could feel a sensation that the world around is moving or spinning (vertigo) or feeling unsteady while walking, blurring of vision, loss of consciousness, feeling light-headed etc.
Common causes
The ear is the main organ responsible for balance. One of the most common cause of vertigo (spinning sensation) is ‘ear balance problem’ or the Benign Paroxysmal Positional Vertigo (BPPV). BPPV is more common among middle-aged and elderly, though it can occur at any age. It may follow trauma, manipulation of the neck, vitamin deficiencies, uncontrolled diabetes, other systemic diseases, sedentary lifestyles, prolonged bed rest etc.
The characteristic feature of BPPV is the feeling of spinning when you change your position like getting up, lying down or turning in bed. It lasts for a few seconds to a few minutes. It may be followed with vomiting, nausea, palpitations, sweating and panic etc.
Usually, it is self-limiting and may be treated with repositioning exercises. Medicines may be needed for a few days to alleviate the symptoms of nausea and vomiting. The repositioning exercises are different for the different semicircular canals involved.
Another common cause of balance problems is vestibular migraine. This is correctable with lifestyle modifications and medications.
Balance problems
Any disease affecting the ear can lead to balance problems like ear infections, trauma and tumours. An ear examination is always warranted for balance problems. Ageing can affect the balance of a person. The causes for balance problems in the elderly can be multifactorial. It may be associated with hearing sounds in one’s ear (tinnitus) or hearing loss, which need to be addressed urgently.
Sometimes it may be the warning sign of strokes and brain disorders. Hormonal problems and cardiac diseases all can be present along with dizziness. A detailed and proper assessment of balance disorders is the key for the diagnosis. Limited investigations like Puretone audiometry (PTA), Video Nystagmography (VNG) and imaging studies (MRI) will help with the diagnosis.
The writer is Consultant ENT Surgeon, Medical Trust Hospital, Kochi.
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