Mini Strokes: Balance Problems And Rehabilitation

can a mini stroke cause balance problems

Strokes can cause balance problems, but can mini strokes, or transient ischemic attacks (TIAs), have the same effect? TIAs are often incorrectly referred to as mini strokes, but they are just as serious and can be a warning sign of an imminent stroke. Balance issues are a recognised symptom of TIAs, along with vision changes, face and arm drooping, and speech difficulties. However, it's important to note that TIAs can affect large areas of the brain and cause a range of symptoms, including severe headaches, nausea, and confusion. If you or someone you know is experiencing these symptoms, it is vital to seek immediate medical attention as every minute counts in preventing a more serious stroke.

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Vertigo and dizziness

Vertigo is often caused by an inner ear problem, specifically the inner ear balance apparatus, or vestibular system. This system sends signals to the brain about head and body movements relative to gravity, helping you keep your balance. When tiny calcium particles, or canaliths, are dislodged from their normal location and collect in the inner ear, it can cause benign paroxysmal positional vertigo (BPPV), a common cause of vertigo. Vertigo can also be caused by Meniere's disease, an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can also be caused by vestibular neuritis or labyrinthitis, an inner ear problem usually related to infection.

Vertigo may also be associated with brain problems such as a stroke or tumour. A stroke can change the way your brain controls balance, and you may feel unsteady or uncoordinated. If the stroke happens in your cerebellum or brainstem, the areas that control balance in the brain, you may experience vertigo.

Dizziness is a range of sensations including feeling light-headed, faint, woozy, giddy, unsteady, off-balance, or weak. It is often caused by problems in the inner ear but can also be caused by other conditions such as low blood pressure and anxiety. Inner ear disorders cause about half of all dizziness cases. Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness, involving brief episodes of intense dizziness related to moving the head. Acute vestibular neuronitis or labyrinthitis is another cause, involving inflammation of the inner ear that can cause sudden, intense vertigo that may persist for several days.

If you are experiencing vertigo or dizziness, it is important to speak to a medical professional. They can advise on treatment options, which may include vestibular rehabilitation, canalith repositioning maneuvers, medication, or surgery.

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Weakness on one side of the body

A stroke can cause weakness on one side of the body, known as hemiparesis. This can make it difficult to balance and limit your movement, affecting all basic activities such as dressing, eating, and walking. The side of the body weakened by hemiparesis could be on the same side as the brain injury, or it could be on the opposite side. For example, a stroke on the right side of the brain could result in weakness on either the right or left side of the body.

Hemiparesis can cause a range of symptoms, including:

  • Trouble maintaining balance, standing, or walking
  • Tingling or numbness on the weak side of the body
  • Difficulty grabbing things or moving with precision
  • Lack of coordination
  • Muscle fatigue

Treatment for hemiparesis may include medical and non-medical techniques such as electrical stimulation, cortical stimulation, and modified constraint-induced therapy (mCIT). It is also important to make lifestyle changes to prevent falls and injuries, such as staying active, wearing wide-toed shoes, using assistive devices, and being attentive when walking.

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Vision problems

If you cannot see clearly around you, it can be harder to make the quick adjustments to your posture and movements to maintain your balance. This can lead to bumping into things or stumbling.

To help with vision problems, it is recommended to have regular eye tests and to wear glasses if you need to. Good lighting in your home can also help, as can keeping spaces free of clutter to better see obstacles.

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Medication side effects

While medications can be lifesaving, they can also cause side effects that may affect your balance. The number of medications you take can also increase the severity and frequency of side effects. Older adults are particularly vulnerable to these side effects, as the body absorbs and responds to drugs differently with age.

Medications that can cause balance problems include:

  • Anticonvulsants/anti-seizure drugs
  • High blood pressure drugs
  • Anti-anxiety drugs
  • Anticholinergic/antispasmodic drugs
  • Antihistamines
  • Antibiotics (especially streptomycin and gentamicin)
  • Aminoglycosides
  • Diabetes drugs (insulin, glipizide, and glyburide)
  • Sleep aids
  • Analgesics/painkillers
  • Chemotherapeutics/anti-cancer drugs
  • Antidepressants
  • Beta-blockers
  • Opioids
  • NSAIDs

It is important to note that you should never stop taking a medication without consulting your doctor first. If you are concerned about how your medications may be affecting your balance, speak to your doctor about reviewing your prescriptions.

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Inner ear problems

The inner ear is responsible for maintaining balance. The labyrinth, a part of the inner ear, is an organ of balance, also known as the vestibular system. It consists of three fluid-filled loops called semicircular canals that respond to the rotation of the head. The utricle and saccule, located near the semicircular canals, detect gravity and back-and-forth motion.

When the labyrinth becomes inflamed, labyrinthitis occurs, resulting in vertigo and imbalance. This condition can be caused by various ear diseases and infections. Additionally, certain medications and alcohol consumption can affect the inner ear, leading to balance issues.

Inner ear disorders, such as benign paroxysmal positional vertigo (BPPV), can cause brief but intense episodes of dizziness, especially when changing head positions. This may be triggered by ageing or head trauma. Acute vestibular neuronitis or labyrinthitis can lead to sudden and intense vertigo, nausea, and vomiting. Although it usually clears up on its own, it may initially require bed rest. Meniere's disease, another inner ear disorder, involves a build-up of fluid pressure in the inner ear, resulting in repeated episodes of vertigo, hearing loss, a feeling of fullness in the ear, and tinnitus.

Vestibular migraines can also cause vertigo lasting from minutes to days, sometimes without a headache. Triggers for vestibular migraines include quick head turns, being in crowded places, driving, or watching TV. They may also result in unsteadiness, hearing loss, and tinnitus.

Anxiety and stress can exacerbate inner ear dizziness symptoms and are common causes of dizziness unrelated to the inner ear.

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