What's Throwing You Off Balance?
Vertigo
It's not a fear of heights, though lots of people think it is. It's not even a "disorder," really. Vertigo is a symptom -- a feeling that either you or the space around you is spinning. This might upset your balance or make you sick to your stomach. Conditions that affect the inner ear cause it most often, but those that have an impact on the brain can also do it.
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Benign Paroxysmal Positional Vertigo (BPPV)
Tiny crystals inside your ear fall into one of the fluid-filled canals, often when you hit your head. Then, when you turn or stand, they confuse your brain and make you dizzy, nauseated, or briefly move your eyes back and forth without control. BPPV can last from a few seconds to a few minutes and usually goes away on its own. Your doctor may treat it with maneuvers that get the crystals to move out of your ear canals.
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Labyrinthitis
A cold or flu virus, or sometimes bacteria, infect the maze of fluid-filled channels deep in your ear. This "labyrinth," which normally helps you keep your balance, swells up, confuses your brain, and causes vertigo. You also might have fever, vomiting, hearing loss, and ringing in your ear (tinnitus). It usually clears up without treatment, but in rare cases, you may need antibiotics to knock out a bacterial infection.
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Vestibular Neuronitis
A virus causes sudden swelling of the vestibular nerve that connects your inner ear and the brain. This could make you dizzy, unsteady, and sick to your stomach, but doesn't normally cause hearing loss or tinnitus. It can last from hours to a few days, but it may take you a month or so to get completely better. It usually clears up on its own, but you might need to rest in bed if your symptoms are bad.
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Meniere's Disease
Though rare, it can cause serious vertigo that lasts from 20 minutes to several hours, often with nausea and vomiting. You might have tinnitus, hearing loss, and a feeling of pressure in your ear. Medicine can cut how many attacks you get and make you feel better when you have one. Diet changes and balance exercises could also help.
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Medication
Your medicine could be the cause of your vertigo. Some drugs that can bring it on are antibiotics, antidepressants, antipsychotics, anticonvulsants, blood pressure meds, and anti-inflammatories. If you notice dizziness or balance issues, don't stop taking your pills, but call your doctor right away. She might suggest something different that won't cause problems.
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Perilymph Fistula (PLF)
A blow to your head can tear a hole in the tissue that divides your air-filled middle ear from your fluid-filled inner ear. This can lead to balance problems. Your ear may ring, feel full, or you may get sensitive to loud noises. Changes in air pressure, like when you're in an airplane, can make it worse. A week or 2 of bed rest gives the hole a chance to heal. Surgery may be an option if you still have problems after 6 months.
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Vestibular Migraine
Food, stress, and other causes of migraine could inflame your vestibular nerve, which sometimes leads to vertigo. You may be dizzy, sick to your stomach, sensitive to light and sound, or have ringing in your ears. Strangely, you might not have an actual headache. You treat it with changes in diet, exercise, sleep, and other habits. Your doctor can add medicine and physical therapy if you need them.
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Head Injury
A hit to the head can disturb your balance in any number of ways. Besides the inner ear damage that leads to vertigo or perilymph fistula, it can also affect your vision, which helps keep you upright. It may also injure parts of your brain that control movement. Treatment depends on what causes the problem. Your doctor and physical therapist might be able to help.
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Motion Sickness
Sometimes riding in a boat, car, train, or plane may make you nauseated and dizzy. It usually stops when you get off the vehicle. But if you have to stay on board, medicine might help. It's also a good idea to:
- Focus on something far away.
- Keep your head still.
- Avoid strong smells, greasy food, caffeine, and alcohol.
- Eat light (plain crackers and water).
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Mal de Debarquement Syndrome
When you step off a boat, you might feel for a moment as if the ground is moving like the ocean. Even professional sailors notice it. Now imagine it doesn't go away. For weeks or years, you rock, bob, or sway -- at least it feels that way -- when you're on solid land. Doctors suspect it's because your brain doesn't readjust when the motion of the journey ends. Most cases get better on their own within a year.
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Neurological Conditions
Illnesses like multiple sclerosis, Parkinson's disease, and cervical spondylosis slowly damage the way your nervous system talks to your brain, which can affect your balance. Physical therapy can help you manage the symptoms.
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Ramsay Hunt Syndrome
You get this condition, and the balance problems that go with it, from the shingles virus that affects a face nerve. It causes a painful rash with fluid-filled blisters around one ear. Your face may be weak and hard to move on the same side. You might also have hearing loss, tinnitus, and vertigo. Call your doctor if you notice these symptoms. Quick treatment with antiviral drugs can help ease pain and keep it from getting worse.
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When to Get Emergency Help
Sudden balance problems may sometimes be a sign of serious problems, like a clot in your blood or a burst blood vessel from a stroke, aneurysm, or embolism. Call 911 right away if you or someone you're with:
- Can't move or feel one or both arms or one side of the face
- Can't see out of one or both eyes
- Speaks in a confused, slurred, or garbled way
- Has a sudden painful headache
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