There are three primary systems that keep us in our plane of space. Our inner ear, our eyes and how we see and react to stimuli in our environment, and our proprioception and how we interpret the world around us through touch. Balance problems can often be attributed to inner ear issues, but did you know that neurological conditions can also play a significant role in disrupting your balance?
Hearing + Balance Clinics specializes in utilizing diagnostic testing to help patients find the correct path to addressing their balance disorders. When our testing shows normal function of the vestibular apparatus, the balance organ in the inner ear, further consultation with a neurologist could be considered. While our testing does not directly diagnose neurological causes of balance disorders, it can tell us whether the symptoms are caused by your inner ear or if they are stemming from your Central Nervous System.
Today, we’re exploring different neurological causes of balance problems and how they can affect your everyday life.
How the Brain Controls Balance
As mentioned above, our ability to maintain balance is a complex process that involves the coordination of several systems: the visual system, the vestibular system in the inner ear, and the proprioceptive system, which includes sensory input from muscles and joints.
The brain collects and processes information from these systems to help you maintain your equilibrium. The disconnect or misinterpretation of sensory input can happen at any step along the process.
However, when there is Central Nervous System involvement or a neurological issue, the brain’s ability to process this information can be impaired, leading to balance problems.
Common Neurological Causes of Balance Disorders
Several neurological conditions can cause or contribute to balance problems, including:
1. Vestibular Migraines
Vestibular migraines are a subset of migraine that affects the processing of information collected by the vestibular system from our inner ear. These migraines can cause dizziness, vertigo, and/or significant balance issues. Unlike typical migraines, vestibular migraines may not always be accompanied by a headache. Like typical migraines, vestibular migraines are cyclical in presentation and can be accompanied by any other migraine symptoms.
2. Multiple Sclerosis (MS)
Multiple sclerosis is an autoimmune disease that affects the central nervous system, including the brain and spinal cord. MS can cause a wide range of symptoms, including balance problems. Lesions or damage in areas of the brain that control movement and coordination can lead to dizziness, unsteady walking, and an increased risk of falls.
3. Parkinson's Disease
Parkinson's disease is a progressive neurological disorder that primarily affects movement. As the disease progresses, it can lead to postural instability, slow movement, muscle rigidity, and tremors—all of which can contribute to balance issues. Patients with Parkinson's may find it difficult to maintain their balance, especially when turning or making sudden movements, which increases their risk of falls.
4. Stroke
A stroke occurs when the blood supply to a part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. This can cause damage to the parts of the brain that control balance and coordination. People who have had a stroke may experience dizziness, difficulty walking, and balance issues, depending on which part of the brain was affected.
5. Cerebellar Ataxia
The cerebellum, located at the back of the brain, plays a crucial role in balance and coordination. Cerebellar ataxia is a condition that occurs when the cerebellum is damaged. Symptoms include unsteady gait, poor coordination, and difficulty with precise movements, which can significantly affect balance.
6. Peripheral Neuropathy
Peripheral neuropathy refers to damage to the peripheral nerves, which transmit signals from the brain and spinal cord to the rest of the body. This condition can result from diabetes, autoimmune diseases, infections, or toxins. When the nerves that control muscle movement and coordination are affected, it can lead to balance problems, numbness, and a sensation of “pins and needles” in the feet and legs.
7. Autonomic Neuropathy
Autonomic neuropathy affects the autonomic nervous system, which controls involuntary bodily functions like heart rate, digestion, and blood pressure. If the autonomic nerves that regulate blood pressure are damaged, standing up quickly can cause a sudden drop in blood pressure, known as orthostatic hypotension, which can lead to dizziness and balance problems.
How Testing could be Suggestive of Neurological Cause of Balance Disorders
Diagnosing a neurological balance disorder involves a thorough evaluation of your symptoms and medical history by a neurologist. Our audiologists use state-of-the-art technology to assess your condition and provide valuable information a neurologist can use in determining if your symptoms are caused by a neurological problem. Some of the diagnostic tests we use include:
Videonystagmography (VNG):
These tests measure involuntary eye movements, called nystagmus. This testing is used to assess your visual ocular reflex and its connection with information provided by the inner ear and their connections with the brain.
Vestibular Evoked Myogenic Potentials (VEMP):
The primary purpose of VEMP testing is to determine if the saccule and the vestibular nerve are intact and functioning properly. When functioning at their best, the saccule and the inferior vestibular nerves work together to send signals to the muscles of the eyes in response to head movements.
Rotary Chair Testing:
This test assesses the vestibular system's response to and recovery from passive movement, providing valuable information about the function of your vestibular organs.
Treatment Options for Neurological Balance Problems
Treatment for neurological balance disorders depends on the underlying cause of your symptoms. Your physician could recommend a range of personalized treatments to help manage and improve balance problems, including:
Videonystagmography (VNG):
These tests measure involuntary eye movements, called nystagmus. This testing is used to assess your visual ocular reflex and its connection with information provided by the inner ear and their connections with the brain.
Vestibular Evoked Myogenic Potentials (VEMP):
The primary purpose of VEMP testing is to determine if the saccule and the vestibular nerve are intact and functioning properly. When functioning at their best, the saccule and the inferior vestibular nerves work together to send signals to the muscles of the eyes in response to head movements.
Rotary Chair Testing:
This test assesses the vestibular system's response to and recovery from passive movement, providing valuable information about the function of your vestibular organs.
Vestibular Rehabilitation Therapy (VRT):
VRT is a specialized form of physical therapy designed to help the brain adapt to changes in the vestibular system. It involves exercises that improve balance, coordination, and stability.
Lifestyle Modifications:
In some cases, changes to diet, hydration, and activity levels may help alleviate symptoms. Patients are also advised to use supportive footwear and assistive devices to prevent falls.
When to Seek Help for Balance Problems
If you are experiencing dizziness, vertigo, or balance problems, it is important to seek medical advice. Early diagnosis and treatment can help manage symptoms, improve quality of life, and reduce the risk of falls.
Hearing + Balance Clinics’ team of experts is dedicated to providing comprehensive testing for balance disorders, ensuring you receive the best treatment tailored to your needs.
Take the First Step Toward Better Balance
Don’t let balance problems affect your independence and quality of life. Speak with your physician about a referral to Hearing + Balance Clinics to schedule a balance assessment and discover how we can help you regain your stability and confidence. With locations in Watkinsville, Loganville, and Lavonia, GA, our clinics are ready to support you on your journey to better balance.
