For patients who have experienced a severe bout of dizziness (see Vestibular Neuritis and Labyrinthitis pages), the recovery phase can be long and difficult. Patients who have experienced this type of problem will usually recover enough to allow them to continue with their previous lifestyles, but for some, the recovery phase falters, and leaves them with an ongoing sense of poor balance. Patients use various terms to describe this such as, ‘walking on sponge’, ‘feeling disconnected with their surroundings’, or ‘not having a true feel for a situation’.
The feeling can be made worse by certain situations and patients learn to avoid these. Typical places avoided are supermarkets, cinemas, theatres,, escalators, patterned floors and crowds of any sort.
Patients who give this type of history have usually learnt to rely excessively upon their eyes to provide them with balance information. They tend to distrust information sent from the inner ears even when the eyes are not the best form of balance input. Balance specialists describe patients like this as having a ‘visual preference’.
Another group of patients will describe difficulty when walking on uneven surfaces. They may be over reliant on information from the balance receptors in the feet, ankles, knees and hips. This information is most useful when the patient is standing still on an even suface. When moving, and particularly when moving on an uneven surface such as cobbles, mud, or sand, the information received is poor. These patients tend to have problems with integrating information from their eyes and the ear balance organs.
In order to help these patients it is essential to get an accurate diagnosis. They have often been given a range of medications to alleviate their symptoms, but in the long term, vestibular exercises customized to their symptoms are the best treatment. Although patients may have a diminished capacity to deal with difficult situations following a balance insult, it is usually possible to increase balance function to the point at which they find it much easier to cope with their work and social life.