There are a number of balance problems that can affect people of all ages. They are broadly broken into causes related to the ears or to the brain, although other medical issues can also be responsible. People with vision impairment, including blindness, can also experience balance problems because their eyes are not providing feedback to the vestibular system, which the body uses to stay in balance. There are treatments available for some disorders involving balance and it is advisable to see a physician if people notice changes in their ability to balance and walk comfortably.
Some balance problems are lumped under the category of vertigo, where people have the sensation that they are spinning or in motion. Examples of conditions in this category are benign paroxysmal positional vertigo (BPPV), Meniere's Disease, labyrinthine infections of the ear, vestibular migraine, and acoustic neuroma. Vertigo can cause people to fall, and it may also lead to gait abnormalities, such as a rolling gait, to compensate for the dizzy feeling.
Other balance problems are related to presyncope, a medical term for “feeling faint.” People with presyncope most commonly have a problem with blood pressure, which causes them to feel faint and unsteady. Disequilibrium, balance disorders characterized by lack of balance and the inability to control the body to stay in balance, can be caused by joint and muscle disorders, inner ear problems, nerve damage such as that seen with multiple sclerosis, and some medications.
Balance problems can also involve feeling lightheaded. People with anxiety disorders sometimes experience balance problems, and hyperventilation can also lead to a lightheaded feeling because the brain is not getting enough oxygen. Brain tumors and other degenerative diseases that attack areas of the brain like the cerebellum can also lead to balance disorders, as people may have trouble controlling their gait or standing upright.
When a balance disorder is identified, a series of diagnostic tests can be used to learn more about why a patient is experiencing problems. These tests can include tilt table tests, stress tests, bloodwork, medical imaging studies of the brain, examination of the ears, and neurological exams. It can be helpful to provide the doctors with as much background information as possible about the patient's history, the onset of the balance problems, and any family history of balance disorders. This information will be considered during the workup of the patient to come up with a list of possible causes and proposed treatments.