Balance disorders and dizziness

Feeling lightheaded, unsteady on your feet, or the sensation that the world is spinning: dizziness can significantly impact your daily life. These symptoms may be related to your vestibular system, but they can also stem from how your brain processes information from your eyes and body.

If symptoms persist, a targeted assessment is essential. At BRAI3N, we determine the approach best suited to your situation. In addition to physical therapy and medication, neuromodulation may be considered for some patients, with the goal of reducing discomfort and helping you regain confidence in your movement.

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how to Treat?

What is it?

What do we mean by dizziness?

Dizziness is not a single condition, but a symptom that can take many forms.
You might feel like you or your surroundings are spinning, that you are unsteady on your feet, that you feel lightheaded, or that moving causes a strange and uncertain sensation.

These symptoms can be disruptive.

Some people are afraid to move their heads, avoid busy environments, or feel insecure while walking, driving, or shopping. When dizziness persists, it can also erode your confidence in your own body.

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How do your brain and your vestibular system work together?

To know where your body is and how you are moving, your brain constantly combines information from several sources:

The vestibular system in the inner earregisters movements and the position of your head.
Your eyesprovide information about your surroundings and movements around you.
Your muscles and joints, including those in your neck, torso, and limbs, provide information about your posture and movement.

The brainstem, the cerebellum, and various areas of the cerebral cortex process these signals together. This creates a coherent picture of your position and movement within your environment. This helps you stay upright, walk steadily, and adjust your movements.

When this information is incomplete, disrupted, or contradictory, it can lead to dizziness or a feeling of instability.

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Why does your gaze remain stable when you move your head?

When you move your head, thevestibulo-ocular reflexensures that your eyes automatically move in the opposite direction. This reflex connects the vestibular system to the eye muscles via the brainstem.

This allows you to keep focusing on text or an object while your head is moving. When this reflex does not function properly, the image may become blurry or appear to jump or shake.

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What are the possible causes of dizziness?

Dizziness and balance problems can be caused by inner ear conditions, such as positional vertigo, vestibular neuritis, or Ménière's disease.

Migraines, medication, blood pressure issues, hyperventilation, neurological conditions, and vision problems can also play a role. Neck issues, for example after whiplash, can also be associated with dizziness. It is possible that altered information from the neck muscles and joints contributes to the symptoms. However, neck pain and dizziness occurring at the same time do not in themselves prove that the neck is the cause.

Anxiety, stress, and persistent tension can exacerbate symptoms. Often, multiple factors play a role simultaneously.

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Why can dizziness become chronic?

After a disturbance of the balance organ, the brain attempts to adapt. It recalibrates the processing of balance signals and learns to make better use of the available information. We call this processvestibular compensation.

Sometimes this adaptation is insufficient. The brain may become overly dependent on visual information, making supermarkets, heavy traffic, or moving images particularly taxing. Increased vigilance and a fear of movement can also help maintain the symptoms.

In this way, dizziness can persist even when the original disturbance has largely resolved. Therefore, if an examination does not find a clear abnormality in the ear, it does not mean your symptoms are imagined. The processing of information in the brain can also play a role. A comprehensive medical assessment remains important.

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How to treat

How do we treat dizziness and balance disorders?

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What working model are we investigating at BRAI3N?

At BRAI3N, we combine clinical experience with neuroscientific research. From our pioneering position, we develop and investigate new perspectives on persistent symptoms.

Research that our team contributed to found differences in people with chronic balance issues regarding the activity and cooperation of brain regions involved in balance, visual attention, and spatial perception. These differences were also measurable outside of a dizziness attack.

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Our working model is that chronic dizziness in a subset of patients is linked to altered cooperation between brain networks and possibly an insufficient inhibition of certain balance signals.

The brain attempts to compensate for this, for example by relying more heavily on visual information.

This is a scientific hypothesis that guides further research. The measured differences do not in themselves show whether they are a cause, a consequence, or an adaptation to the symptoms.

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Persistent dizziness can undermine your confidence in your body. Walking, working, or going to a busy store sometimes becomes a challenge. At BRAI3N, we want to understand what causes and maintains your symptoms. The goal is to reduce the burden and give you more confidence in your daily life again.

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Treatment tailored to your symptoms

Dizziness can have various causes. A medical assessment, for example by an ear, nose, and throat (ENT) specialist, therefore forms an important foundation. When a treatable cause is found, it receives a targeted approach.

Depending on your situation, different treatments can complement each other:

Physical therapy and vestibular rehabilitation:targeted exercises for balance, gaze stability, and managing movement. Vestibular rehabilitation can help if the vestibular system is underperforming. Associated neck complaints and neck muscle tension also deserve attention.
Medication:can be useful for certain causes or associated symptoms. The choice and duration of use are discussed with the attending physician.
Psychotherapy:can provide support for fear of movement, persistent tension, and the impact of dizziness on your daily life. You would pursue this guidance outside of BRAI3N, for example, with a psychologist in your area.

Stress can exacerbate symptoms, but that does not mean the dizziness is imagined. Sleep, tension, and avoidance behavior can therefore also be part of the approach.

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What is the role of neuromodulation?

For some people with chronic dizziness, neuromodulation can be considered as a supplement to other treatments. In this process, we attempt to influence the activity of nerve pathways and brain networks involved in processing balance signals.

A possible technique at BRAI3N isC2 stimulation. Through electrodes on the skin, a weak electrical current is applied to the back of the head, in the area of the occipital nerves. The goal is to reduce dizziness symptoms and their impact by influencing the vestibulo-ocular reflex system in the brainstem.

A qEEG, an analysis of electrical brain activity, can provide additional information on how the brain is compensating for missing or abnormal information. If the adaptation process—vestibular compensation—is insufficient, dizziness persists.

Neuromodulation is not a miracle cure. We discuss the possibilities and limitations in advance and evaluate whether the treatment offers sufficient added value for you.

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Our four-phase approach

1. Assessment
We discuss your symptoms, medical history, previous examinations, and the impact on your daily life. Together, we determine achievable treatment goals.

2. Targeted treatment
We start an individual treatment plan and monitor changes in dizziness, balance, and daily functioning. If results are insufficient, we adjust or stop the treatment in question.

3. Stabilization
When the treatment helps, we try to consolidate the improvement. Where possible, we gradually reduce the frequency of treatment.

4. Maintenance
We determine whether further follow-up or maintenance treatment is necessary. The principle is: as little treatment as necessary.

After each phase, we evaluate the next step together.

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