Are you one of the 69 million Americans who suffer from vestibular dysfunction?
Do you or a loved one, suffer from dizziness or balance disorders? Do not wait until a fall makes you aware of this issue. Integrative Assessment Technique provides a template to evaluate these types of disorders, by examining ones structure, emotions and biochemistry.
A recent survey revealed that 69 million Americans over age 40—more than 35 percent—have some form of vestibular dysfunction, such as dizziness or balance problems, which increases the risk of a serious fall (Women’s Health advisor, August 2009). Survey results also showed that people with diabetes were 70 percent more likely to have vestibular dysfunction than people without diabetes.
“Vestibular dysfunction is a serious problem; it can potentially lead to falls, concussions, and fractures. The researchers found that people who were symptomatic (i.e., felt dizzy or off-balance) had a 12-fold increased risk of falling,” says Mukesh Prasad, MD, associate professor of clinical otorhinolaryngology atWeillCornellMedicalCollege.
“Unfortunately, many people fail to report episodes of dizziness or imbalance to their physicians, often because they are afraid that something very serious, such as a tumor, is causing their symptoms,” explains Dr. Prasad. “These study results emphasize the importance of reporting balance problems or dizziness to your primary care physicians; the earlier these problems are identifies, the better your chances are of preventing a fall.”
Many possible causes
Vestibular dysfunction may be caused by a wide variety of health conditions. “Visual deficits, nerve deficits, inner ear problems such as Meniere’s disease and benign paroxysmal positional vertigo (BPPV), arthritis, migraines, and increased stress and anxiety are possible causes,” says Dr. Prasad. One of the most common causes is BPPV, a common condition of the inner ear in which tiny calcium crystals called otoconia are dislodged from their appropriate location in the ear, which causes a sensation of vertigo or spinning. Other possible causes include head injury, stroke, viral infections, and high doses of certain anti-biotics.
People with diabetes are more likely to suffer from vestibular dysfunction because they often develop neuropathy, or nerve damage. This damage occurs more frequently in the legs and feet and can cause pain, tingling, and/or numbness, which diminishes the person’s ability to maintain balance. Medications also cause vestibular dysfunction. “Many times, it’s the combination of drugs rather than one drug,” says Dr. Prasad.
But in many cases, a specific cause for the imbalance is not found. According to Dr. Prasad, this is not cause for alarm, since the condition can still be treated.
Treatment options
Treatment depends on the cause, if a cause is identified. For example, visual deficits can often be resolved with corrective lenses, such as eyeglasses or contact lenses. Better control of pain and stiffness from arthritis with chiropractic care, exercises and/or medication can improve balance. Diabetic neuropathy requires better control of blood glucose levels, usually combining diets, exercise, and medications.
Inner ear problems such as BPPV and Meniere’s disease often require diagnosis and treatment by an otolaryngologist, a doctor who specializes in ear, nose, and throat disorders. With BPPV, the doctor moves the patient’s head and body in a series of different positions, called the Epply maneuver, to get the otoconia back into their proper place, which stops the spinning sensation. Meniere’s disease, which may cause a ringing or roaring sound in the ears, hearing loss, pressure, or pain as well as dizziness, is thought to occur due to a change in fluid volume in the inner ear. Treatments that may lessen symptoms include dietary changes that reduce fluid retention, smoking cessation, stress reduction, medication, and in severe cases, surgery.
If you take any medications, especially two or more, your doctor needs to review all of your medications and determine which single drug or interaction between drugs may be causing your symptoms and make the appropriate reductions or changes in the medications.
A specialized physical therapy program called vestibular rehabilitation can assess causes of vestibular dysfunction and provide treatment.
Final words
“It’s amazing that people don’t think twice about needing glasses or dental work, but they neglect to report dizziness or balance problems to their doctors,” says Dr. Prasad. “Vestibular dysfunction is similar to sleep apnea—people used to be embarrassed about snoring, so they often didn’t report it. But once they found out about all the health problems associated with sleep apnea, and that snoring is a symptom, they reported it and got necessary treatment.
source: Weill Cornell Medical College, Women’s Health advisor, Volume 13/ Number 8/ August 2009
