Balance disorders, diagnosis and treatment

Diagnosing a balance disorder is not easy. If the family doctor has suspicions, he will surely refer us to an otolaryngologist. You may request a hearing test, blood test, video-stagmography (a test that measures eye and muscle movements), or imaging studies of the head and brain. You can also order a post-turograph, to accurately measure your ability to balance on a moving platform with different configurations. You may also have other tests, such as the swivel chair test, the head jerk test, or even tests that measure eye or neck muscle responses to short sound clicks. Because the vestibular system is complex, multiple tests may be needed to better assess the cause of the balance problem.

01:07 - The first thing the otolaryngologist must do is determine if the balance problem may be due to some other medical problem or medication. If so, the doctor will treat that problem, suggest a change in medication, or refer us to another specialist if the medical problem is outside his or her scope. If the problem is Benign Paroxysmal Positional Vertigo, the otolaryngologist may be able to make a series of simple movements, such as the Epley maneuver, to help dislodge calcium carbonate crystals, called otoliths, that have fallen into the semicircular canal, thus preventing normal functioning of the vestibular system. In many cases, a single session is sufficient. In others, the procedure needs to be repeated several times until the dizziness can be relieved.

02:02 - If we are diagnosed with Ménière’s disease, the otolaryngologist may recommend certain changes in diet and to stop smoking, if appropriate. Medications for vertigo or nausea may relieve the symptoms, but may make you sleepy. Other medications, such as gentamicin (an antibiotic) or corticosteroids, may also be used. Although gentamicin works better than corticosteroids to reduce dizziness, it sometimes causes permanent hearing loss, in addition to kidney damage. In some severe cases of Ménière’s disease, surgery on the vestibular organs may be necessary.

02:46 - Some people who have a balance disorder are unable to relieve their dizziness completely and must find ways to live with it. A vestibular rehabilitation therapist can help prepare an individualized treatment plan. It is important to ask if you can still drive, and how to decrease the risk of falls and injuries during our daily activities, such as using the stairs, bathroom, or exercise. Walking in the dark should be avoided, as well as having unstable shoes, it is better to use those with low heels and rubber soles. If necessary, use a cane or walker, make any necessary modifications at home or at work, for example, adding handrails or railings.

03:39 - And so far for today, I hope I’ve been helpful. Thank you very much, and until the next video! .