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Annette Hanshaw - I've Got a Feeling I'm Falling
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Whatever the position of your head, gravity pulls on these grains, which then move the stereocilia to signal your head's position to your brain. Any head movement creates a signal that tells your brain about the change in head position. When you move, your vestibular system detects mechanical forces, including gravity, that stimulate the semicircular canals and the otolithic organs.
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These organs work with other sensory systems in your body, such as your vision and your musculoskeletal sensory system, to control the position of your body at rest or in motion. This helps you maintain stable posture and keep your balance when you're walking or running. It also helps you keep a stable visual focus on objects when your body changes position. When the signals from any of these sensory systems malfunction, you can have problems with your sense of balance, including dizziness or vertigo.
If you have additional problems with motor control, such as weakness, slowness, tremor, or rigidity, you can lose your ability to recover properly from imbalance. This raises the risk of falling and injury. Diagnosis of a balance disorder is difficult. To find out if you have a balance problem, your primary doctor may suggest that you see an otolaryngologist and an audiologist. An otolaryngologist is a physician and surgeon who specializes in diseases and disorders of the ear, nose, neck, and throat.
An audiologist is a clinician who specializes in the function of the hearing and vestibular systems. You may be asked to participate in a hearing examination, blood tests, a video nystagmogram a test that measures eye movements and the muscles that control them , or imaging studies of your head and brain.
Another possible test is called posturography.
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For this test, you stand on a special movable platform in front of a patterned screen. Posturography measures how well you can maintain steady balance during different platform conditions, such as standing on an unfixed, movable surface. Other tests, such as rotational chair testing, brisk head-shaking testing, or even tests that measure eye or neck muscle responses to brief clicks of sound, may also be performed.
The vestibular system is complex, so multiple tests may be needed to best evaluate the cause of your balance problem. The first thing an otolaryngologist will do if you have a balance problem is determine if another health condition or a medication is to blame.
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If so, your doctor will treat the condition, suggest a different medication, or refer you to a specialist if the condition is outside his or her expertise. If you have BPPV, your otolaryngologist or audiologist might perform a series of simple movements, such as the Epley maneuver, to help dislodge the otoconia from the semicircular canal.
In many cases, one session works; other people need the procedure several times to relieve their dizziness. Anti-vertigo or anti-nausea medications may relieve your symptoms, but they can also make you drowsy. Other medications, such as gentamicin an antibiotic or corticosteroids may be used. Although gentamicin may reduce dizziness better than corticosteroids, it occasionally causes permanent hearing loss. Some people with a balance disorder may not be able to fully relieve their dizziness and will need to find ways to cope with it.
A vestibular rehabilitation therapist can help you develop an individualized treatment plan. Talk to your doctor about whether it's safe to drive, and about ways to lower your risk of falling and getting hurt during daily activities, such as when you walk up or down stairs, use the bathroom, or exercise. To reduce your risk of injury from dizziness, avoid walking in the dark.
Wear low-heeled shoes or walking shoes outdoors. If necessary, use a cane or walker and modify conditions at your home and workplace, such as adding handrails. To help you decide whether to seek medical help for dizziness or balance problems, ask yourself the following questions. You can help your doctor make a diagnosis and determine a treatment plan by answering the questions below. Be prepared to discuss this information during your appointment. Scientists supported by the National Institute on Deafness and Other Communication Disorders NIDCD are studying animal ears to learn if inner-ear structures that help with balance but are destroyed by aging, medications, infections, or trauma can someday be regrown in people with balance problems.
Other NIDCD-supported scientists are testing vestibular prostheses—miniature devices that may be worn outside the body or implanted into the ear to regulate the function of balance organs in the inner ear and ease dizziness. Some of these devices are being tested on volunteers in clinical trials, and others are still being developed.
NIDCD-funded scientists are also working to develop much-needed tests to appropriately diagnose balance disorders. Standardized tests will help doctors determine the best way to help individuals restore their sense of balance and quality of life. These tests will also help us understand how many people suffer from balance disorders, and track whether the sense of balance is restored following treatment.
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The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language. On this page: What is a balance disorder?