Frequently Asked Questions

Find answers to neurotology questions below.

What is a balance disorder?

A balance disorder is a condition that makes you feel unsteady or dizzy, as if you are moving, spinning, or floating, even though you are standing still or lying down. Balance disorders can be caused by certain health conditions, medications, or a problem in the inner ear or the brain.

How many people have balance disorders?

The exact number of people affected by vertigo is difficult to quantify. Often, symptoms are difficult to describe. However, studies consistently show that vestibular disorders are underdiagnosed and undertreated.

According to the Vestibular Disorders Association, more than a third of US adults aged 40 years and older (69 million Americans) have vestibular problems. And, dizziness is a common symptom affecting about 30% of people over the age of 65.

How do balance problems affect people’s quality of life?

Adults with chronic dizziness often find that activities of daily living are more difficult. Bathing, dressing, eating, getting around inside the home may become a challenge. People reporting dizziness are also at risk for falling, which could cause further injury or impairment.

What controls my sense of balance?

Our sense of balance is primarily controlled by a maze-like structure in our inner ear called the labyrinth, which is made of bone and soft tissue. At one end of the labyrinth is an intricate system of loops and pouches called the semicircular canals and the otolithic organs, which help us maintain our balance. At the other end is a snail-shaped organ called the cochlea, which enables us to hear. The medical term for all of the parts of the inner ear involved with balance is the vestibular system.

What are the symptoms of a balance disorder?

If your balance is impaired, you may feel a spinning or floating sensation, some lightheadedness, blurred vision, or a feeling like you’re going to fall. Other symptoms could include confusion, nausea and vomiting, changes in heart rate and blood pressure, and fear, anxiety or panic. Symptoms may come and go.

When should I see a doctor?

Talk with your doctor if you can answer "yes" to any of these questions:

Do you:

• Feel unsteady?
• Feel as if the room is spinning?
• Feel as if you’re moving when you know you’re standing still?
• Lose you balance and fall?
• Feel as if you’re falling?
• Feel lightheaded?
• Have blurred vision?
• Feel disoriented?
• What is a neurotologist?

Neurotologists are otolaryngologists (ear, nose, throat or ENT doctors) who have completed additional training in medical and surgical diseases of the ear, skull base, and related structures, as well as the connections between the ear and the brain. If you have seen your family doctor or an ENT but need a more specific diagnosis, call a neurotologist.

How can I prepare for my first appointment?

You can help your doctor make a diagnosis and determine a treatment plan by being prepared to answer the questions below:

• The best way I can describe my dizziness or balance problem is:
• How often do I feel dizzy or have trouble keeping my balance?
• Have I ever fallen? If so, When and where?
• Under what conditions did I fall?
• How often have I fallen?

Take along a list of medications you take, including prescription medications and over-the-counter medicine, such as aspirin, antihistamines, or sleep aids. Note the name, dosage and reason you are taking the medication.

How is a balance disorder diagnosed?

Diagnosis of a balance disorder is often difficult because there are many potential causes. Your family doctor may suggest that you see a specialist, such as a neurotologist. The neurotologist will likely request a hearing exam, blood tests and special balance tests, such as electronystagmogram and posturagraphy.

How are balance disorders treated?

The first thing a doctor will do to treat a balance disorder is determine if your dizziness is caused by a medical condition or medication.

Your doctor also may describe ways for you to handle daily activities to reduce your risk of falling.

If you have BPPV, your doctor might prescribe a series of simple movements, called the Epley maneuver, to help dislodge the otoconia from the semicircular canal.

If you are diagnosed with Ménière's disease, your doctor may recommend changes in your diet, such as reducing the use of salt in your food and limiting alcohol and caffeine. Not smoking also may help. Surgery on the vestibular organ may be necessary if you have a severe case of Ménière's disease.

Some people with a balance disorder need to learn ways to cope with it on a daily basis. A vestibular rehabilitation therapist can help by developing an individualized treatment plan that combines head, body, and eye exercises to decrease dizziness and nausea.