Dizziness, imbalance and spinning sensations are often dismissed as weakness, low blood pressure or ageing. But these may be symptoms of an underlying disorder, which in some cases can have a life-threatening cause and may require specialised diagnostic evaluation and multimodal treatment, including vestibular physiotherapy, psychotherapy and where appropriate, medication too.
You feel the room move when it isn't moving. While standing, you feel dizzy, as if you are not anchored well enough to the ground and your surroundings. You turn your head and the world spins. Sometimes there is no spinning at all — just a persistent imbalance with a fear of losing balance or falling.
Its causes can range from diseases of the inner ear to the brain, spinal cord, eyes, heart and blood vessels, and may also be due to metabolic, psychological or cognitive disorders. The balance system is intimately and reciprocally connected with the psychic and cognitive systems. Hence, diseases in the balance system can induce psychic disorders like anxiety / depression and vice versa. Psychic and cognitive disorders contribute majorly to the malady of the balance disorder patient. This aspect needs to be diagnosed and managed by trained experts.
From Tanzania to India — and back home with a new sense of balance
{{/usCountry}}From Tanzania to India — and back home with a new sense of balance
{{/usCountry}}A recent patient at the Institute of Neurotology, Centre of Excellence for Vertigo & Balance Disorders at Pacific OneHealth, Lajpat Nagar, shows why balance disorders may need more than just symptom -suppressing medication and that with a multidisciplinary diagnosis and multimodal treatment, patients can re-join mainstream and get back the independence and confidence that they have lost.
The patient travelled from Tanzania to India with an incapacitating balance disorder, having a constant feel of spinning, dizziness, persistent unsteadiness and an agonising fear of fall. Walking, standing and even turning his head had become not only a challenge but a traumatic experience. He feared getting out of the house, was not attending office, and always needed a physical support. He was continuously on symptom suppressing vestibular sedatives with absolutely no benefit, rather had worsening of his symptoms
Under the care of the multidisciplinary team of the Institute of Neurotology, comprising medical and paramedical personnel, he underwent a detailed evaluation of the balance system — both clinical and instrumental — that included a thorough psycho-cognitive evaluation. The cause of his distressful symptoms was finally diagnosed. Accordingly, treatment was instituted that comprised specialised vestibular physiotherapy, psychotherapy and a minimum of medication, definitely not the symptom-suppressing medicines but medicines to treat the disease causing the symptoms. Before returning to Tanzania, he completed sessions of vestibular physiotherapy with the Centre’s dedicated vestibular physiotherapist and psychotherapy with the vertigo department’s psychologist. The psychotherapy sessions are still continuing online after his return to Tanzania.
Two weeks after his return home came a photograph that said more than any medical report. The patient sent a picture of himself standing on one leg on a tree stump, arms out, eyes closed and smiling — exhibiting the balance, the confidence, the independence, and the joy of regaining the sense of balance that he had long lost.
For me, being a doctor, there is no better report card than this.
Beyond the ear: Understanding the whole balance system
Balance depends on the brain integrating information from the inner ear, eyes, muscles and joints. When these systems do not work in harmony, or if the brain malfunctions, there is dizziness / instability /vertigo.
Depending on the cause, patients may need medical expertise spanning neurotology, neurology, psychology / psychiatry, cardiology, internal medicine, physiotherapy and audiology.
Vertigo is not just a symptom of a disease in the balance system. It affects a person’s independence, confidence, social life, profession and peace of mind. Treating the whole person — the ear, the brain and the mind together — is what makes a lasting recovery possible.
Pacific OneHealth's perspective on vertigo and balance disorders
Pacific OneHealth Hospitals is India's specialist-led healthcare facility, bridging the healthcare “missing middle” between neighbourhood clinics and tertiary hospitals through technology-enabled treatments.
The Institute of Neurotology & Centre of Excellence for Vertigo & Balance Disorders brings together consultation, vestibular diagnostics, rehabilitation therapy and balance training. Its multidisciplinary model recognises that balance disorders may require different specialists and treatment modalities. (Pacific One Health)
Specialised neurotology, built around comprehensive care
The Institute of Neurotology & Centre of Excellence for Vertigo & Balance Disorders at Pacific OneHealth focuses on the evaluation and management of vertigo, dizziness, balance disorders, hearing loss and tinnitus through a specialised, multidisciplinary approach.
The approach is anchored in individual experience in neurotology, shaped by experts across the Association of Otolaryngologists of India, the Neurotological and Equilibriometric Society of India, and the Indian Academy of Otolaryngology, Head and Neck Surgery, as well as the Vice-Presidency of the International Neurotological and Equilibriometric Society. This clinical foundation is further enriched by long-standing editorial, academic and research contributions to the Indian Journal of Otolaryngology & Head and Neck Surgery, and through books and scientific publications on vertigo and deafness.
Specialist care, closer to patients
Pacific OneHealth’s network spans Lajpat Nagar, Karol Bagh and Dwarka. Its Lajpat Nagar facility provides specialist care alongside imaging, integrated diagnostics, emergency and critical-care services. (Pacific One Health)
For patients with recurring dizziness, the aim is to connect specialist evaluation, diagnosis, rehabilitation and follow-up.
Don’t learn to live with unexplained dizziness
Repeated spinning, imbalance, unexplained dizziness or fear of falling should not be attributed to low blood pressure, weakness, stress or ageing.
The question is not only “How do I stop the dizziness?” It is “Why am I getting dizzy?”
The experience of a patient who travelled from Tanzania to India for care and returned home continuing his recovery is a reminder that balance disorders deserve to be understood, not merely silenced.
The article is written by Dr. Anirban Biswas, Principal Director - Institute of Neurotology & Centre of Excellence for Vertigo & Balance Disorders, Pacific OneHealth Hospitals, Lajpat Nagar, New Delhi.
For more information, please visit: www.pacificonehealth.com