Balance and Dizziness

Balance is an equal distribution of weight in order to remain steady or upright.[1] Body balance plays an important part on our body to function normally in our daily activities. We maintained this by equally distributing our body weight in every movement without losing our balance.

 

HOW DOES THE BODY MAINTAIN BALANCE?

Body balance is maintained by three peripheral sources that send sensory input signal to the brain in the form of nerve impulses. These peripheral sources are:

  • Eyes (Vision)
  • Muscle and Joints (Proprioception/touch receptors in the feet, trunk and spine)
  • Vestibular system (Inner Ear)

Signals from these three peripheral sources were integrated in the brain specifically in the cerebellum, cerebral cortex and brainstem which works together and categorizes the signal to send motor impulses to control eye movement and make postural adjustment to maintain balance.

Vestibular system analyzes sensory information about motion, equilibrium and spatial orientation provided by the vestibular apparatus found in the inner ear. These apparatus found in the ear includes utricle and saccule which detects vertical orientation and linear movement and the 3 semicircular canal which detects rotational movements. The semicircular canals were located right angle to each other and filled with fluid (endolymph). When head position changes and displaces cupula (a small cup shaped structure in the vestibular system), the receptor sends nerve impulses to the brain about the movement which provides a sense of head position. An abnormality or malfunction of vestibular can lead to balance problem or vertigo.

 

WHAT DOES IT MEAN WHEN SOMEONE SAYS “I FEEL DIZZY”?

Dizziness is not a precise term and it can be used to describe different feelings. So what should you interpret when your friend says he or she is feeling dizzy?

Feeling dizzy, can refer to a feeling of lightheadedness. Lightheadedness is often a prequel to fainting and if it persists and does not improve, it can ultimately lead to fainting, more commonly known as “passing out” of the person. When you feel lightheaded, you do not feel your surroundings to be moving and the feeling can improve or go away if you lie down for a while. There may be a feeling of nausea and vomiting might occur. It is not uncommon for normal people to feel lightheaded occasionally but if the feeling is persistent, you should report to your doctor as soon as possible.

Vertigo is a feeling of movement without any actual movement. When you feel vertigo, there will be a feeling of moving, spinning or floating even when you are in a steady state in standing, sitting or lying posture. And if you are walking, you might fall over because of vertigo. Standing up and regaining balance will prove difficult if vertigo persists.

 

WHAT CAUSES DIZZINESS?

Dizziness can be due to different emotional and physical factors such as:

  • Anxiety
  • Side effects of medications: medicines such as beta blockers, nitroglycerin, diuretics, ACE inhibitors, medicines for erectile dysfunction (Viagra) can cause dizziness.
  • Sudden drop in blood pressure which may occur while suddenly standing up (postural hypotension)
  • Pregnancy
  • Anemia
  • Hypoglycemia
  • Labyrinthitis
  • Heart disease
  • Alcohol use
  • Dehydration
  • Weakness

 

HOW TO TREAT DIZZINESS?

Dizziness is a symptom, not a disease. Identifying the exact location of the source of dizziness should be more specific to target of treatment. The causes listed above should be treated and eradicated to eliminate the feeling of dizziness e.g. dizziness arising from a condition of hearth rhythm disturbance can only be alleviated by correcting heart function and rhythm. Similarly, bleeding and fluid loss can be treated by blood or fluid transfusion to treat dizziness associated with this.

Vertigo arising from inner ear disturbances can be treated with specific maneuvers such as Epley and Semont maneuvers. Patient can be taught these to use at home. Medications can also be prescribed for vertigo occasionally which might improve the severity of symptoms. Patients with vertigo associated with serious diseases of ear such as Meniere’s disease should be referred to specialist ENT physician (Otolaryngologists) for proper treatment of the disease.

 

[1] Google Dictionary. https://www.google.com.sg