Balance disorders can disrupt a person’s ability to maintain stability and coordination, leading to dizziness, vertigo, or unsteadiness. They may result from inner ear problems, neurological conditions, or injuries. These disorders can significantly impact daily life, making diagnosis and treatment essential for restoring mobility and confidence. Recognizing the symptoms early can pave the way for effective management.
How Does the Body Maintain Balance?
Our brain, ears, eyes, joints, and muscles work together to keep us balanced and upright. If any of these systems don’t function properly, it can lead to balance disorders. These issues can occur at any age, and symptoms in kids and teens might be overlooked or attributed to other causes. Children with balance problems may seem clumsy or uncoordinated, struggling with activities like walking, riding a bike, schoolwork, or playing sports.
Signs & Symptoms of a Balance Disorder
The severity of balance disorder symptoms can vary from mild to serious. Very young children might not be able to explain how they feel, while older kids and teens may describe feelings of dizziness, lightheadedness, or disorientation.
Common signs include:
- Unsteady walking: Difficulty standing, walking, turning, or climbing stairs, often stumbling or tripping.
- Legs far apart: Walking with legs wide apart or holding onto things to avoid falling.
- Vertigo: The sensation of spinning or feeling as though the surroundings are moving.
- Nausea and vomiting
- Motion intolerance (e.g., car sickness)
- Vision problems: Involuntary eye movements or difficulty focusing.
- Headaches or migraines
- Delayed development or frequent falls
- Fatigue and feeling unwell
- Emotional symptoms: Anxiety, fear, panic, or depression
Children may also experience hearing issues, such as muffled sounds, ear pain, or ringing in the ears (tinnitus). Balance issues can make it difficult to hear, concentrate, and keep up with schoolwork. Physical activities like gym class or sports might also be more challenging.
Types of Balance Disorders
Balance disorders in kids and teens include:
- Benign paroxysmal torticollis of infancy: Causes dizziness, leading children to tilt their heads.
- Benign paroxysmal vertigo of childhood (BPVC): Sudden vertigo episodes, often brief, that stop on their own.
- Benign paroxysmal positional vertigo (BPPV): Triggered by changes in head position, causing brief spinning sensations.
- Vestibular neuritis: Inflammation of the vestibular nerve caused by viral infections, affecting balance.
- Labyrinthitis: A viral or bacterial infection affecting the inner ear, causing hearing loss and balance problems.
- Post-concussion syndrome: Dizziness and balance problems following a concussion.
- Vestibular migraine: A migraine accompanied by dizziness or vertigo.
Less common balance disorders include perilymph fistula (PLF), semicircular canal dehiscence, and Meniere’s disease.
Causes of Balance Disorders
Balance disorders may result from:
- Ear injuries
- Head or neck injuries
- Ototoxicity (medications that harm the ear)
- Middle ear infections or cholesteatoma
- Motion sickness
- Migraines
- Hearing loss
Genetic factors can also play a role if balance problems, migraines, or hearing issues run in the family.
Diagnosing Balance Disorders
Doctors will perform a physical exam, review the child’s medical history, and may refer the child to specialists like audiologists, otolaryngologists (ENT doctors), physical therapists, or neurologists. Diagnostic tests include:
- Imaging tests (MRI or CT scans)
- Hearing tests
- Electronystagmogram (ENG) or videonystagmography (VNG) to monitor eye movements
- Vestibular evoked myogenic potential (VEMP) to test muscle and eye reactions
- Video head impulse test (vHIT) to assess inner ear function
- Rotary chair testing
- Posturography, which measures the ability to balance
Treating Balance Disorders
Treatment depends on the cause. Some balance disorders improve on their own, while others may need medication, surgery, or physical therapy. Balance training (vestibular rehabilitation) with a therapist may include exercises to strengthen muscles and improve coordination.
Treating hearing loss may also improve balance.
When to Call the Doctor
Although occasional dizziness or clumsiness can be normal, persistent signs of a balance disorder require medical attention. Early diagnosis and treatment can help children improve their balance, coordination, and overall well-being. If symptoms are frequent, contact your doctor to investigate.