Balance Problems & Dizziness

Balance problems such as dizziness are one of the most common complaints people bring to their doctors - in fact, it’s estimated that up to 40% of adults experience dizziness severe enough to report it to a physician. However, it’s one of the most difficult complaints to assess as it is a highly subjective sensation and may be caused by several overlapping pathophysiological processes that invariably result in balance problems. It is therefore important to recognise the different signs that could indicate problems with balance to ensure timely and appropriate intervention.

signs

Common signs of balance problems

Dizziness, one of the most common signs of balance problems, often occurs alongside other symptoms. If you experience any of the following symptoms alongside your dizziness, we recommend undergoing balance diagnostics:

  • Repeated light-headedness
  • Spinning sensations/vertigo
  • Floating sensations
  • Sensations of being pushed/ pulled
  • Blurred/ double vision
  • Feeling confused/ inability to coordinate movements
  • Nausea/ vomiting
  • Unsteadiness/ disequilibrium
  • Leaning/ veering to one side when walking
  • Fullness in ears
  • Fluctuating hearing loss
  • Tinnitus
  • Brain fog
  • Anxiety/ panic attacks
  • Headaches/ migraines
  • Increased sensitivity to light and sound
  • Motion sickness
  • Neck pain

CAUSES OF BALANCE PROBLEMS

Although balance impairment may arise from a whole host of different health disorders and bodily systems, inner ear balance problems are often found to be involved - the inner ear balance system is otherwise known as the vestibular system. Read more about how the ear works. The following diseases/ disorders linked to the vestibular system commonly lead to balance problems:

Benign Positional Paroxysmal Vertigo (BPPV)

The most common cause of vertigo, BPPV is caused by misplaced calcium crystals in the vestibular system and results in short bursts of dizziness provoked specifically by head movements.

Vestibular Neuronitis

Caused by viral inflammation of the vestibular nerve leading to dizziness and imbalance.

Labyrinthitis

Viral or bacterial inflammation of the inner ear nerves leading to dizziness and hearing loss.

Vestibulopathy

Damage to vestibular organs that leads to imbalance and anxiety.

Trauma

Head injuries may cause damage to the structures in the vestibular system leading to dizziness and imbalance.

Ototoxic Medication 

Can cause permanent damage to the vestibular system, typically resulting in imbalance, hearing loss and tinnitus. Ototoxic medication includes some types of chemotherapy drugs.

Meniere’s Disease

A progressive condition caused by inner ear fluid imbalance leading to attacks of dizziness, tinnitus, pressure in ears and increasing hearing loss. 

Superior Canal Dehiscence Syndrome

An anatomical change/ thinning in the bone overlying the vestibular end organ that leads to aural fullness, tinnitus, and sound/ pressure induced dizziness.

Vestibular Migraine 

Caused by temporary changes in brain activity that leads to motion intolerance, dizziness and visual disturbance.

VESTIBULAR & BALANCE DIAGNOSTICS

Our sense of balance is intricately connected to mechanisms of the ears, eyes, brain, muscles, and nerves throughout the body. Balance diagnostics is therefore a complex process, typically involving a battery of tests. Our experts will begin an evaluation by initially taking a detailed medical history and performing a physical examination. They will then run a series of tests in order to determine the nature and severity of any underlying balance problems. These tests primarily focus on recording and analysing eye movements that are generated by the vestibular (inner ear balance) system and central nervous system, which both play primary roles in a healthy functioning balance system on the whole.

A vestibular balance assessment may include the following where appropriate:

  • Audio-vestibular/medical history and balance evaluation questionnaires.
  • Clinical Otoscopy – performed to inspect the condition of the outer ear and ear drum in order to detect any abnormalities or contra-indications
  • Pure Tone Audiometry – a test to identify hearing thresholds and the degree of any loss
  • Tympanometry – a test to examine the health of the middle ear and ear drum movement
  • Dix Hallpike Manoeuvre - a dynamic head positioning manoeuvre to detect an abnormality in vestibular end organ response
  • Video Head Impulse Testing (vHIT) - a test to determine the function of vestibular end organs through a series of rapid head movements
  • Vestibular Evoked Myogenic Potentials (VEMPs) - a test to measure the function of vestibular end organs involving sound stimulation and muscle tissue recordings
  • Videonystagmography (VNG) - a test to detect abnormalities in eye movements in response to different stimuli and head positions
  • Bi-thermal Caloric Testing - a test to determine the function of vestibular end organs via temperature stimulation using warm and cold air
  • Consultation and individual management plan
  • Onward referral to ENT/ other specialists for further medical evaluation as appropriate
  • Comprehensive audio-vestibular report or e-report provided to you and/ or your referring specialist

Contact us

For further information on the services and products we offer, please visit the relevant page from the menu. To book an appointment, please get in touch below.

The service is only available at our Canary Wharf clinic and is open to self-referrals.