Doctor Audiologist Emel Uğur

Dr. Audiologist Emel Uğur was born in 1982 in Çanakkale. During her 15-year tenure at Istanbul Training and Research Hospital, she primarily worked on Pediatric Audiology (Hearing Loss in Infants and Children), Otological Diseases (Ear Diseases and Hearing Health), and Vestibular System Disorders (Vertigo and Imbalance). In 2015, she joined the Acıbadem Healthcare Group.

About Me

What is a Balance Disorder?

This condition can occur for various reasons and is generally associated with inner ear problems. The brain gathers the necessary information to maintain the body’s balance from different sources:

• Eyes
• Muscles and joints
• Inner ear

If there is a problem in the inner ear, the brain receives incorrect information. This causes the individual to experience imbalance and dizziness.

What Are the Effects of Balance Disorders on Mental Health?

The root of this condition lies in the uncertainty and insecurity created by balance disorders. Patients often avoid social interactions, which can eventually lead to isolation and, consequently, depression. This is particularly evident in those who experience severe dizziness. Problems in the inner ear can create not only physical issues but also psychological repercussions:

• Hearing loss
• Tinnitus
• A feeling of fullness in the ear

Balance disorders are not just a physical ailment; they can deeply affect mental health as well.

What Are the Causes of Balance Disorders?

Dizziness and balance disorders can result from various health problems. Positional dizziness, such as in BPPV, can be triggered by sudden movements or changes in position. Inner ear diseases or head trauma are among the primary causes of dizziness and balance disorders. Labyrinthitis, known as an inflammation of the inner ear, occurs as a result of a cold or flu, causing inflammation in the inner ear channels and leading to severe vertigo. Additionally, this condition can cause confusion and sometimes vomiting along with tinnitus.

Vestibular neuritis is generally an inner ear problem caused by viruses. It is known for the inflammation of the nerves that transmit information from the inner ear to the brain, and it presents with symptoms such as dizziness, imbalance, and nausea.

Meniere’s disease is a condition with an unknown exact cause that leads to prolonged vertigo attacks. Its symptoms include nausea, vomiting, hearing loss, and a feeling of pressure in the ear. A perilymphatic fistula is another balance disorder caused by head trauma or drastic changes in air pressure. It occurs when fluid from the inner ear leaks into the middle ear, resulting in tissue tears and causing some serious symptoms:

• Balance problems
• Sensitivity to loud sounds
• Tinnitus

Vestibular migraine occurs when inflammation develops in the vestibular nerve as a result of food, stress, and other migraine triggers. It presents with symptoms such as dizziness, nausea, hypersensitivity to light and sound, and tinnitus.

What Are the Symptoms of Vertigo?

Vertigo is a condition in which a person feels as if they or their surroundings are spinning. This condition is usually associated with inner ear problems and manifests with various symptoms. In addition to a spinning sensation, an individual experiencing vertigo may also experience the following symptoms:

• Nausea and vomiting
• Abnormal eye movements
• Excessive sweating
• Hearing loss or tinnitus

These symptoms may vary depending on the severity of the vertigo and the individual’s overall health. In contrast to vertigo, a balance disorder is characterized by the inability to remain stable. People with balance disorders generally exhibit the following symptoms:

• A sensation of walking on a bouncy bed
• Blurred vision
• Imbalance while walking

These types of symptoms can be grouped under the general category of dizziness; however, they are not always caused by vertigo.

What Are the Treatment Approaches?

The treatment of dizziness and balance disorders is tailored to the underlying causes of the symptoms. In cases of positional vertigo, corrective maneuvers specific to the pathology determined through tests are applied. This treatment method can rapidly improve the patient’s condition. In the case of Meniere’s disease, treatment aims to alleviate attacks and reduce symptoms, while lifestyle changes are encouraged during the intervals between attacks:

• Reducing triggering stress factors,
• Encouraging regular exercise and an active lifestyle,
• Providing professional psychological support when necessary.

In Meniere’s disease, it is also recommended to avoid factors that could trigger attacks:

• Salty foods,
• Products containing alcohol and caffeine,
• Smoking.

Since the natural course of the treatment is individualized, approximately 85% of patients benefit from medical treatments, while various interventional treatments may be employed for the remaining patients. These include:

• Intratympanic treatments,
• Local high-pressure applications,
• Placement of a ventilation tube,
• Endolymphatic sac surgery,
• Vestibular neurectomy.

In cases of dizziness caused by acute or chronic middle ear inflammations, these inflammations must be treated using appropriate methods.

What Medical Conditions Cause Dizziness?

Circulatory disorders, in which insufficient blood reaches the brain, cause dizziness. Individuals with high blood pressure, diabetes, and high cholesterol often experience this condition. Reduced blood flow disrupts the delicate balance in the inner ear and triggers a specific type of dizziness known as vertigo.

Cardiovascular issues:

• Arteriosclerosis
• Heart failure
• Anemia

Additionally, skull injuries can affect the structure of the inner ear, leading to severe vertigo and hearing loss. As functions become impaired, dizziness may persist for a period of time. Common infections, such as those caused by viruses or colds, can disrupt the nerve connections between the inner ear and the brain, resulting in vertigo. Bacterial infections, on the other hand, can cause both balance problems and hearing loss.

• Main types of infections:
• Viral infections
• Bacterial infections

Allergic reactions can sometimes also manifest as dizziness and vertigo. Allergens in the environment or foods that trigger allergic reactions can cause imbalances in the body. Finally, diseases affecting the nervous system also lead to imbalance. Neurological disorders such as multiple sclerosis or tumors are significant factors in the disruption of balance.

Neurological disorders:

• Multiple sclerosis
• Syphilis
• Brain tumors

How Do the Balance Systems Work?

The human body has a complex mechanism for perceiving movement and maintaining balance. The sense of balance is made possible by the integrated operation of various systems that send information about the body’s position and direction of movement to the brain to coordinate actions.

• The inner ear or labyrinth detects when the body is rotating and determines the direction of movement.
• The eyes establish spatial position and the direction of movement.
• The joints and spine detect which part of the body is lower and in contact.
• Muscles and joints identify the moving parts of the body.
• The central nervous system processes the information from these systems and ensures coordination.

Each system has its specialized functions and continuously communicates with the others. For example, while the inner ear detects angular head movements and changes in acceleration, the eyes evaluate the surrounding visuals to provide information about the body’s position. Pressure receptors in the joints sense gravity and contact, while sensors in the muscles and joints determine which parts are in motion.

Frequently Asked Questions

Which vitamin deficiency causes balance disorders?

One of the common causes of balance disorders is vitamin deficiencies. In particular, the primary reason seen in elderly individuals is a deficiency of Vitamin B12. Vitamin B12 is crucial for the nervous system and muscle coordination. Low levels of B12 can lead to neurological disorders and, consequently, balance problems. A deficiency can result in symptoms such as an ataxic gait and imbalance. Additionally, gastrointestinal diseases can lead to B12 deficiency, which in turn causes balance issues. Therefore, balance disorders can be caused by Vitamin B12 deficiency.

Does Vitamin D deficiency cause balance disorders?

Yes, Vitamin D deficiency can cause balance disorders. Case-control studies have shown that Vitamin D deficiency predisposes individuals to positional dizziness. In particular, the likelihood of recurrent BPPV is higher in the presence of Vitamin D deficiency. Moreover, Vitamin D plays an important role in maintaining the balance of calcium and phosphorus in the body. A lack of this vitamin leads to weakened bones and impaired mineralization. As a result, this bone weakening can lead to balance problems and an increased risk of falls. This condition, especially observed in the elderly, can cause significant difficulties in daily activities. Therefore, adequate intake of Vitamin D is critical for maintaining balance health.

What are the diseases that cause balance disorders?

Among the conditions that lead to balance disorders, the most commonly encountered is the displacement of ear crystals, known as BPPV. Meniere’s disease occurs due to increased fluid pressure in the labyrinth. Meniere’s is a chronic condition characterized by a combination of auditory and balance disorders. Additionally, labyrinthitis, an infection of the inner ear labyrinth, can also lead to balance problems. It is an acute condition that requires emergency treatment and can cause significant hearing loss. In the case of vestibular neuritis, inflammation of the vestibular nerve leads to balance loss, although hearing remains normal. In pathologies arising from the inner ear or vestibular nerve, significant balance disorders can occur even if the individual does not perceive them. Therefore, a detailed audio-vestibular evaluation is necessary from a functional perspective.