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Fall 2011


Botsford HealthSource Magazine

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Balance Disorders: What to Watch for and How to Find Help

Regaining Your Balance
Balance Disorders: What to Watch for and How to Find Help Women don’t have to fall victim to injuries from balance disorders.

Balance disorders tend not to get as much attention as some of the other conditions that typically affect women. Yet the risks of falling are very real. In 2010, 45.3 percent of the visits to the Botsford Trauma Center were due to falls.

What Makes Us Out of Balance?
Bruce Cassidy, D.O.
, an internal medicine physician at Botsford Hospital, says that many falls are related to some type of balance disorder. In some cases, balance disorders are age-related. "As women get older, they can gradually lose strength, and problems with balance that lead to falls are a part of that," Dr. Cassidy explains.

William Boudouris, DO But not all balance disorders and falls are related to age. Another common cause is neuropathy. Put simply, neuropathy is the loss of sensation in the arms, legs, hands or feet. The most common instance of neuropathy is as a complication of diabetes.

Some types of dementia can also lead to balance problems. One type of dementia that causes balance problems—normal pressure hydrocephalus, or NPH—occurs when there is too much fluid on the brain. If detected early enough, NPH can be treated with a shunt used to drain the fluid, says William D. Boudouris, D.O., a neurologist at Botsford Hospital.

Some women also experience balance problems due to vertigo, the feeling of motion even though you are standing still. "One common cause of this is a disorder of the inner ear known as benign paroxysmal positional vertigo, or BPPV," says Dr. Boudouris. This type of vertigo is typically short-lived, but it can be dangerous when it increases the risk of falling.

There are also instances when balance disorders in women can be a side effect of medication. For example, chemotherapy is one common treatment that increases weakness and your risk.

Diagnosing Balance Disorders
Expert physicians at Botsford Hospital diagnose women with balance disorders and, more importantly, help them and relief. "If it's related to muscle deconditioning due to age, it's generally pretty easy to identify," Dr. Boudouris says. "The proper course of action here is to work closely with a physical therapist to build strength and work on balance techniques." Doctors can generally identify age-related balance problems with a thorough medical history and physical examination.

If the doctors suspect neuropathy, they might conduct an electromyography (EMG) test. This involves stimulating the nerves of the affected arms or legs with small electrical charges to determine if they are working properly.

If the problem is related to dementia or vertigo, then a trip to Botsford’s Radiology Department for magnetic resonance imaging, or MRI, may be in order. This can give the doctor a clearer picture of the brain to identify any concerns.

When medication is involved, Dr. Cassidy says the doctor and patient will need to weigh the pros and cons of the treatment and determine whether there is a suitable alternative.

Treating the Conditions
At Botsford Hospital, most balance issues are very treatable. Though treatment of balance disorders is highly specialized based on the cause, and can involve medication or surgery in some cases, a common strategy is working with a physical therapist at one of the hospital's many rehabilitation centers. These professionals can perform balance assessments and come up with a specific exercise routine to help the individual build strength and enhance their balance.

Another important issue is that patients need to be willing to use assistive devices. "A lot of older patients don’t like to use canes or walkers, but they can help prevent a lot of problems" says Dr. Boudouris.


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