UC HEALTH LINE: Dizziness, Fatigue May Be Sign of Balance Disorder

CINCINNATI—Just about everything you do in your daily life—whether it’s walking, driving a car or brushing your teeth—requires balance.

For most people balance is so instinctive they don’t think about it—until dizziness or disorientation signals that something has gone wrong.

And when that happens, UC’s Balance Center is one of few comprehensive care facilities in the area available to diagnose and treat the problem.

Maintaining balance depends on three complex processes, says Julie Honaker, director of audiology in the UC Department of Otolaryngology–Head and Neck Surgery: the sensory system’s ability to accurately determine the body’s position relative to the environment (standing up, for example), the brain’s ability to process that information, and the coordinating movement of the muscles and joints.

The body’s balance sensors include the eyes, the sense of touch, and the inner ear—where calcium carbonate “otolith particles” and fluid inside three paired canals stimulate hair cells to generate senses of forward, backward and vertical motion in the head.

The Balance Center offers various tests that examine all the balance sensory systems and a person’s ability to execute coordinated movements, both voluntary and involuntary, to maintain balance.

Already one of the best equipped of its kind, UC’s Balance Center recently updated equipment and added several new tests, all of which provide a more comprehensive look at the inner ear balance system than standard technology. They are:

·         A rotational chair: UC is one of the first comprehensive balance centers in the area to offer this test. Patients are seated in a chair that rotates at different speeds to measure their eye movements. The chair features multiple testing options that focus on different aspects of balance function.

·         Platform posturography: This series of tests measures how well patients can maintain their balance while the walls and floor of the booth in which they are standing are gradually moved.

·         VEMP (vestibular evoked myogenetic potential): This technique measures responses from the saccule, one of the otolith organs in the inner ear, to sound stimulation, including high-intensity acoustic stimuli, clicks and low-frequency tones. 

“So many conditions can cause dizziness and disorientation,” says Honaker. “We’re like detectives when we evaluate and test people for balance disorders, because of all the conditions that must be ruled out as the cause. That’s why we’re really excited to add this equipment to our center—it gives us more in-depth options for what’s causing a patient’s balance issues.”

People can develop balance problems because of inner ear conditions, head injury, stroke or other neurological issues, she explains.

“Balance disorders can really disrupt a person’s life,” adds Ravi Samy, MD, assistant professor of otolaryngology. “They can cause fatigue, shorten the attention span, disrupt sleep patterns and increase the risk of falling, making it difficult to do everyday tasks.”

Balance problems also increase with age, and Honaker, currently studying the risk and fear of falling in the elderly, hopes to establish a program for at-risk patients.

“We’re an aging population, so it’s important to offer safety and counseling tips to help those at risk of falling,” she says. “I’m hoping to develop a multidisciplinary approach, which would include primary care, geriatric and neurology physicians among others.” 

For more information on balance disorders, visit www.netwellness.org, a collaborative health-information Web site staffed by Ohio physicians, nurses and allied health professionals, or call (513) 475-8453 to schedule an appointment at the Balance Center.