Health

We get our sense of balance from the interaction of several different receptors. There are pressure receptors in our feet, muscle tension receptors in our joints and muscles, we receive input from our eyes, and there are balance organs in our inner ears on each side. These receptors all send a signal to the central processor—the brain. The brain interprets all the inputs and determines where we are in space. If any of those inputs are absent, decreased, or faulty our brain is not able to be certain where we are in space, and we feel off balance or dizzy.

Dizziness is a generic term and can be used to express several different symptoms, which can usually be broken down into more specific symptoms. The more specific we can be with the symptoms, the easier it will be to determine the actual cause. The specific symptoms are: lightheadedness, ataxia or dis-coordination, and vertigo. Approximately 10 % of the population suffers from dizziness, and nearly one-half of people over 65 complain of dizziness.           

When people are lightheaded, they will usually say that they feel like their “head is in a fog” or that they feel “faint.” Most visits to the doctor for dizziness are actually for lightheadedness, which can be caused by several different conditions These include blood flow problems (low blood pressure, cardiac rhythm abnormalities), visual problems, aging, and anxiety. Ataxia is not very common. The movement of our muscles is coordinated through a part of the brain called the cerebellum. The communication wires of the cerebellum run through our brain stem. When something disrupts or injures either of these parts of our brain, we have trouble coordinating the movement of our muscles. This is called ataxia. Ataxia may be caused by tumors that press on the cerebellum or brainstem, strokes, TIAs (transient ischemic attacks), or trauma.

The sensation of your environment moving around you, or less commonly of you moving and the environment standing still, is called vertigo. Vertigo is most often caused by a problem in the inner balance system or one of its pathways. It can also be caused by a problem with the brain (the central processor). Central vertigo may result from migraine headaches, stroke, TIA, brain tumors, or conditions like multiple sclerosis or Parkinson’s disease. The inner ear balance systems are paired, like twin engines on an airplane. They function in an “equal and opposite” fashion. If one of the “engines” is working at a different level (either giving more input, or giving less input) than the opposite “engine,” the brain interprets it as motion (vertigo). Peripheral vertigo is best broken down based on how long the actual sensation of motion lasts. Benign paroxysmal positional vertigo is the most common cause, resulting in vertigo that can last seconds to minutes. Other causes include Meniere’s disease (vertigo lasts minutes to hours), infection of the inner ear (vertigo lasts 1-2 days), drugs, trauma, and tumors.