A balance disorder is a persistent or recurring feeling of unsteadiness, spinning or light-headedness. Balance depends on the inner ear, the eyes, sensation from the feet and joints, and the brain areas that combine them. A fault in any of these can cause it.
It is a symptom with many possible causes, most of them benign and treatable. Describing exactly what you feel, how long episodes last and what sets them off is the most useful information for the doctor, and often points to the diagnosis before any test.
Symptoms
- Vertigo: a false sense that you or the room are spinning
- Unsteadiness when walking, veering to one side
- Light-headedness or feeling faint on standing
- Nausea and vomiting with attacks
- Hearing loss, ringing or fullness in one ear
- Blurred or jumping vision on head movement
- Falls or fear of falling
Causes and risk factors
The commonest inner ear cause is benign paroxysmal positional vertigo, in which loose crystals trigger seconds of spinning on turning in bed or looking up. Vestibular neuritis causes days of severe vertigo after a viral illness. Meniere's disease gives attacks lasting hours with hearing changes. Vestibular migraine is frequent and may occur without headache. Other causes include low blood pressure on standing, medicines (sedatives, blood pressure tablets, some antibiotics), nerve damage in the feet from diabetes, anxiety, stroke or multiple sclerosis affecting the brainstem or cerebellum, and rarely a vestibular schwannoma.
How it is diagnosed
- History and bedside examination: Eye movements, the head impulse test, gait and lying and standing blood pressure.
- Dix-Hallpike manoeuvre: A positional test that confirms BPPV and shows which ear is involved.
- Hearing test (audiometry): One-sided hearing loss points to Meniere's disease or a nerve tumour.
- Videonystagmography and caloric testing: Measure how each inner ear balance organ is working.
- MRI of the brain and inner ear canals: When a central cause or vestibular schwannoma is suspected.
- Blood tests and ECG: Look for anaemia, glucose problems and rhythm disturbances in people with faintness.
Treatment options
- Repositioning manoeuvres: The Epley or similar manoeuvre clears BPPV in one or two sessions in most people.
- Vestibular rehabilitation: Tailored exercises that retrain the brain to compensate. Effective after neuritis and for chronic unsteadiness.
- Short-term medication: Anti-sickness and vestibular sedatives for a few days in acute attacks only. Long use delays recovery.
- Meniere's disease management: Salt reduction, betahistine in some countries, and steroid or gentamicin injection through the eardrum for resistant attacks.
- Migraine prevention: Lifestyle triggers and preventive medicines when vestibular migraine is the cause.
- Medication review and falls prevention: Reducing culprit drugs, strength and balance training, footwear and home safety.
When it is urgent
Sudden dizziness with double vision, slurred speech, facial droop, limb weakness or numbness, a new severe headache, or inability to stand may be a stroke. Call emergency services. Dizziness with chest pain, fainting or sudden hearing loss in one ear also needs urgent local care.
Travelling to Türkiye for treatment
Most balance problems are diagnosed and treated close to home, and flying during active vertigo is unpleasant. A visit may be worthwhile if months of symptoms remain unexplained and you want full vestibular testing, audiometry and MRI assessed together in a few days. Rehabilitation exercises then continue at home over weeks.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
الأسئلة المتكررة
Is vertigo the same as dizziness?
Vertigo is one type of dizziness, the illusion of movement. It usually points to the inner ear or its brain connections.
Will it come back?
BPPV recurs in perhaps a third of people over several years and is treated the same way again. Neuritis usually happens once.
Should I rest until it passes?
Only in the first day or two of a severe attack. After that, moving normally speeds the brain's compensation.
Could it be a brain tumour?
That is rare. Progressive one-sided hearing loss with unsteadiness is the pattern that warrants an MRI.