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How is a balance disorder treated?
The first thing a doctor will do to treat a balance disorder is determine
if your dizziness is caused by a medical condition or medication. If it is,
your doctor will treat the condition or suggest a different medication.
Your doctor also may describe ways for you to handle daily activities
that increase the risk of falling and injury, such as driving, walking up or
down stairs, and using the bathroom. If you have BPPV, your doctor might
prescribe a series of simple movements, called the Epley maneuver, to help
dislodge the otoconia from the semicircular canal. You begin the Epley
maneuver by sitting upright, with the help of a trained therapist, then
quickly lie down on your back, turn your head to one side, and wait for a
minute or two before sitting back up again (see Figure 3). For some people,
one session will be all that is needed. Others might need to repeat the
procedure several times at home to relieve their dizziness.
If you are diagnosed with Ménière's disease, your doctor may recommend
changes in your diet, such as reducing the use of salt in your food and
limiting alcohol and caffeine. Not smoking also may help. Some anti-vertigo
or anti-nausea medications may relieve your symptoms, but they can also make
you drowsy. Other medications, such as the antibiotic gentamicin or
corticosteroids, may be injected behind the eardrum to reach the inner ear.
Although gentamicin helps reduce dizziness, it occasionally destroys sensory
cells in the cochlea and causes permanent hearing loss. The risk of hearing
loss can be lowered if small doses of gentamicin are given off and on until
your symptoms decrease. Corticosteroids don't cause hearing loss; however,
research is underway to determine if they are as effective as gentamicin.
Surgery on the vestibular organ may be necessary if you have a severe case
of Ménière's disease.
Some people with a balance disorder may not be able to fully relieve
their dizziness and will have to develop ways to cope with it on a daily
basis. A vestibular rehabilitation therapist can help by developing an
individualized treatment plan that combines head, body, and eye exercises to
decrease dizziness and nausea.
To reduce your risk of injury from dizziness, avoid walking in the dark.
You also should wear low-heeled shoes or walking shoes outdoors and use a
cane or walker if necessary. If you have handrails in the home, inspect them
periodically to make sure they are safe and secure. Modifications to
bathroom fixtures can make them safer. Conditions at work may need to be
modified or restricted, at least temporarily. Driving a car may be
especially hazardous. Ask your doctor's opinion about whether it's safe for
you to drive.