Brain injury effects
Balance problems & dizziness after a brain injury
Dizziness and balance problems are
common after a brain injury, and can result in problems with
movement even when there is no loss of function in the limbs
Our sense of balance comes from the interaction of three
systems in our body - our eyesight, the inner ear (the vestibular
system), and proprioception which is our brain's ability to sense
where parts of our body are spatially.
Problems with balance can stem from damage to any
parts of these systems, and a brain injury can affect all three.
For example the trauma of a traumatic brain injury can damage the
inner ear, while a stroke could affect parts of the brain
responsible for our sense of balance.
Other possible causes
- infection or trauma to the inner ear
- low blood pressure
- medication side effects.
Diagnosis of dizziness or balance
Due to this complexity, diagnosis usually involves a thorough
medical examination, which may start with your GP and could go on
to involve physiotherapists, neurologists, neurosurgeons and
optometrists. Tests may include a CT scan, MRI scan or EEG
Write down all your symptoms in detail and take these to
your doctor or rehabilitation team. Include what you were doing at
the time of your symptoms, what else was happening, and the time of
day. Also take a list of all your medications.
Treatment depends upon the nature of the balance disorder, and
if a specific cause can be identified. If the specific cause is
treatable, then that is the best option. Some conditions can be
improved with dietary changes such as reducing salt, caffeine,
nicotine or alcohol.
Another treatment option is vestibular rehabilitation - balance
retraining exercises which are sometimes combined with electrical
stimulation or biofeedback to more effectively train the muscles.
Physical aids are somtimes used along with therapy, such as
braces, splints or moulded shoe inserts.
Other treatments involving training the brain can include training
an individual to rely more heavily on visual cues if proprioception
can no longer be completely trusted.
Invasive surgical procedures that may be used can include
correction of joint or limb contraction, shortening or lengthening
limbs or, in some cases, severing proprioceptive nerves to prevent
None of these techniques, as useful and effective as they can be,
should happen in isolation. Environmental modifications, such as
the addition of handrails in the home or the use of a walking stick
or frame, and safety education, are also desirable.
If you have not yet been able to access treatment, or if it is
not yet working, there are some tips you can follow to improve your
quality of life while suffering from a traumatic brain injury
or other type of brain disorder affecting your
- Don't use alcohol and other drugs
- Get out of bed slowly and allow time to adjust to changed
- Stop the moment dizziness starts and sit or lie down
until it passes
- Avoid or slow down movements that unbalance you
- Sleep without a pillow to keep your neck and backbone perfectly
- Cut down on salt as this can increase the sensation of
- Pinpoint times or conditions when dizziness is worse, and avoid
those conditions or schedule activities to avoid those
References and further information