Vertigo

A balance disorder is a disturbance that causes an individual to feel unsteady, giddy, woozy, or have a sensation of movement, spinning, or floating. The effect of spinning is known as vertigo. Although annoying, this disorder is usually harmless, and can be treated simply and effectively.

Recommended reading: Conquer Your Vertigo And Motion Sickness.

Normal balance functioning
 
Illustration of the flow of fluid in the ear, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. Also shows the utricle and saccule-otolithic organs that are responsible for detecting linear acceleration, or movement in a straight line.
This figure shows nerve activity associated with rotational-induced physiologic nystagmus and spontaneous nystagmus resulting from a lesion of one labyrinth. Thin straight arrows--direction of slow components; thick straight arrows--direction of fast components; curved arrows--direction of endolymph flow in the horizontal semicircular canals: AC--anterior canal, PC--posterior canal, HC--horizontal canal.An organ in our inner ear, the labyrinth, is an important part of the vestibular system which is responsible for balancing the body. The labyrinth interacts with other systems in the body, such as the visual (eyes) and skeletal (bones and joints) systems, to maintain the body's position. These systems, along with the brain and the nervous system, can be the source of balance problems.

Three structures of the labyrinth, the semicircular canals, let us know when we are in a rotary (circular) motion. The semicircular canals, the superior, posterior, and horizontal, are fluid-filled. Motion of the fluid tells us if we are moving. The semicircular canals and the visual and skeletal systems have specific functions that determine an individual's orientation. The vestibule is the region of the inner ear where the semicircular canals converge, close to the cochlea (the hearing organ). The vestibular system works with the visual system to keep objects in focus when the head is moving. Joint and muscle receptors also are important in maintaining balance. The brain receives, interprets, and processes the information from these systems that control our balance.

Movement of fluid in the semicircular canals signals the brain about the direction and speed of rotation of the head--for example, whether we are nodding our head up and down or looking from right to left. Each semicircular canal has a bulbed end, or enlarged portion, that contains hair cells. Rotation of the head causes a flow of fluid, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. Two other organs that are part of the vestibular system are the utricle and saccule. These are called the otolithic organs and are responsible for detecting linear acceleration, or movement in a straight line. The hair cells of the otolithic organs are blanketed with a jelly-like layer studded with tiny calcium stones called otoconia. When the head is tilted or the body position is changed with respect to gravity, the displacement of the stones causes the hair cells to bend.

The balance system works with the visual and skeletal systems (the muscles and joints and their sensors) to maintain orientation or balance. For example, visual signals are sent to the brain about the body's position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular and the skeletal systems. An example of interaction between the visual and vestibular systems is called the vestibular-ocular reflex. The nystagmus (an involuntary rhythmic eye movement) that occurs when a person is spun around and then suddenly stops is an example of a vestibular-ocular reflex.

Types of balance disorders
Some of the more common balance disorders are:

Benign Paroxysmal Positional Vertigo (BPPV)--a brief, intense sensation of vertigo that occurs because of a specific positional change of the head. An individual may experience BPPV when rolling over to the left or right upon getting out of bed in the morning, or when looking up for an object on a high shelf. The cause of BPPV is not known, although it may be caused by an inner ear infection, head injury, or aging.
Labyrinthitis--an infection or inflammation of the inner ear causing dizziness and loss of balance.
Ménière's disease--an inner ear fluid balance disorder that causes episodes of vertigo, fluctuating hearing loss, tinnitus (a ringing or roaring in the ears), and the sensation of fullness in the ear. The cause of Ménière's disease is unknown.
Vestibular neuronitis--an infection of the vestibular nerve, generally viral.
Perilymph fistula--a leakage of inner ear fluid to the middle ear. It can occur after head injury, physical exertion or, rarely, without a known cause.

Causes
Infections (viral or bacterial), head injury, disorders of blood circulation affecting the inner ear or brain, certain medications, and aging may change our balance system and result in a balance problem. Individuals who have illnesses, brain disorders, or injuries of the visual or skeletal systems, such as eye muscle imbalance and arthritis, may also experience balance difficulties. A conflict of signals to the brain about the sensation of movement can cause motion sickness (for instance, when an individual tries to read while riding in a car). Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort. Balance disorders can be due to problems in any of four areas:

Peripheral vestibular disorder, a disturbance in the labyrinth.
Central vestibular disorder, a problem in the brain or its connecting nerves.
Systemic disorder, a problem of the body other than the head and brain.
Vascular disorder, or blood flow problems.

Symptoms
When balance is impaired, an individual has difficulty maintaining orientation. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. Some of the symptoms a person with a balance disorder may experience are:

A sensation of dizziness or vertigo (spinning).
Falling or a feeling of falling.
Lightheadedness or feeling woozy.
Visual blurring.
Disorientation.
Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period of time.

Treatment
There are various options for treating balance disorders. One option includes treatment for a disease or disorder that may be contributing to the balance problem, such as ear infection, stroke, or multiple sclerosis. Individual treatment will vary and will be based upon symptoms, medical history, general health, examination by a physician, and the results of medical tests.

Vertigo
A patient with Vertigo feels that everything is spinning around. These effects can be frightening, but are rarely serious in nature. The cause is usually that a foreign body has been dislodged in the inner ear, and the brain is receiving erroneous messages. The treatment is to move the particle away, or remove it altogether.

Exercises done in the Home
These exercises are intended to shift the object(s) to a new location where they are no longer effective in causing the problem. The following article explains with diagrams how these exercises can be performed in the home or at the office (surgery): [1]

The two exercises explained in the above article are:

The Brandt-Daroff Exercises, which can be done safely at home and have a very high (95%) success rate.
The Epley Exercises, which can either be done by a Doctor in the surgery, or at home. These exercises are immediately effective, but have a slightly lower success rate (80%).

Removal of the foreign body from the Ear
The treatment can be as simple as having one or both ears sluiced. This procedure will remove objects causing the problem. This treatment can be easily performed by the doctor, and will remove the problem at source.

Drugs
Drugs are sometimes prescribed, but these usually treat the symptoms rather than the underlying cause. These drugs are similar to those designed for the treatment of motion sickness. The above exercises tend to be more effective as a preventative measure.

Surgery
As a method to treat this problem, surgery is quite rare and the least desirable. The less invasive techniques above are preferred.

Balance Retraining exercises
Another treatment option includes balance retraining exercises (vestibular rehabilitation). The exercises include movements of the head and body specifically developed for the patient. This form of therapy is thought to promote compensation for the disorder. Vestibular retraining programs are administered by professionals with knowledge and understanding of the vestibular system and its relationship with other systems in the body.