What is a Balance Disorder?

Balance disorders are very difficult to diagnose and treat because there is often more than one underlying cause. Knowledge of all the sensory systems that contribute to balance as well as how each system works together and interacts with the brain is essential.

How are balance disorders caused?

• Benign Positional Vertigo (BPPV) – BPPV is the number one cause of all dizziness. It involves intense, brief episodes of vertigo associated with a change in the position of your head, often when you turn over in bed or sit up in the morning.
• Vestibular Neuronitis – inflammation of the inner ear
• Ménière’s Disease – a buildup of fluid in the inner ear
• Vestibular Migraine – dizziness and vertigo that may or may not be accompanied by headaches
• Head Trauma
• Multiple Sclerosis
• Stroke and heart attack
• Slow-growing tumors
• Joint and muscle weakness
• High or low blood pressure
• Viral infections

How are balance disorders diagnosed?

• Case History: one of the most important components in diagnosing balance disorders. Details about the imbalance can often determine which part of the inner ear or brain is involved.
• Diagnostic Hearing Evaluation: the hearing system and the vestibular system are very close in physical proximity. They function together. Any part of the ear can cause and/or contribute to a loss of balance.
• Auditory Brainstem Response: tests both the ear and the brain by measuring the timing of electrical waves from the brainstem.
• Voluntary Eye Movement Testing: measures the ability to coordinate eye movements with head movements crucial for walking, driving, etc.
• Videonystagmography (VNG): computerized testing that measures, records and analyzes eye movements under various conditions.
• Computerized Dynamic Posturography (CDP): measures and tracks all of the components (eyes, inner ear, muscles and joints) involved in maintaining balance.

How are balance disorders treated?

Treatment of balance disorders consists of Vestibular Rehabilitation and Balance Retraining. An individual treatment plan is designed for each patient based upon the patient’s history, the findings from the diagnostic testing performed and the functional limitations caused by the imbalance.

The goals of all treatment plans are:

• Decreasing or eliminating dizziness/vertigo
• Improving balance function and safety
• Improving visual motor control and tolerance of motion
• Increasing activity levels
• Reducing falls or risks of falls

Ronna Fisher

Dr. Ronna Fisher, AuD, CCC-A, FAAA is the founder and president of Hearing Health Center, which she established in 1984 in memory of her father, who suffered from untreated hearing loss and died at 53. That personal loss has shaped her entire career. Under her leadership, Hearing Health Center has been voted the best hearing practice in Illinois three years in a row by Hearing Review. In 2005, she expanded her mission by founding the Fisher Foundation for Hearing Health Care, a nonprofit dedicated to making auditory care more accessible. Dr. Fisher earned her doctorate in audiology from the Pennsylvania College of Optometry and holds a Certificate of Clinical Competence in Audiology (CCC-A) from the American Speech-Language-Hearing Association. She is a Fellow of the American Academy of Audiology and a member of the Academy of Dispensing Audiologists. Today, Dr. Fisher is focused on the growing body of research linking untreated hearing loss to dementia and cognitive decline, and committed to making sure both patients and the medical community understand what is at stake. As she puts it: You can't remember what you didn't hear.

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