What Causes Poor Equilibrium After A Head Injury?

Hello. Thanks for asking form HCM. I can understand your concern. The equilibrium is maintained by internal ear, cerebellum, some tracts in spinal cord and vision. I have mentioned all these so that we can rule out damage to any of above one by one. : Internal ear has vestibular apparatus which is necessary for balance. It can get damaged if injury occurs directly to ear/fracture of temporal bone. If you are having any earache, ear discharge, history of ear injury or temporal bone fracture, involvement of it can be suspected. Treatment includes consult ENT specialist. He will do some tests to find out the degree of damage. He may prescribe medicine like beta-histine or Cinnarizine for relief. He will ask you to use broad base walk to avoid fall. Temporary damage will recover completely. Another good point is that opposite side normal vestibular apparatus will gradually take over all function. : Visual system - Vision helps us in judging distance, depth and thus walk and run. If you are having any kind of visual blurring or decreased vision, you should get your vision checked up.Glasses amy be needed to correct any kind of refractive error. : Cerebellum - Injury to occiput or upper neck area can cause injury to it. It controls balance in collaboration with vestibular system. Permanent damage to it lead to irreversible balance difficulty. For relief, physiotherapy is needed to strengthen muscles, learn broad base walk, avoid dark areas. Support with stick may also help. It is less likely in your case as you are having intermittent difficulties. : Tracts in spinal cord - There are few tracts made up of nerves which are present in spinal cord. These tracts control over muscles of hand and foot and thus help in maintaining balance. Damage of these will manifest as weakness of limbs, tightness and balance difficulty. In your case it is less likely as you are able to move and having intermittent complaints. Another common cause is head injury impact. Sometimes injury can cause vertigo or balance problem for few days. It will resolve on its own. To fasten relief, you can follow few tips : Maintain hydration by drinking 2.5 to 3 litre of fluids daily : Avoid darkness : Daily exercise to increase basal vasomotor tone which will prevent postural hypotension and thus vertigo sensation while standing from sitting position : You can take drugs like Beta-histine or Cinnarizine after proper prescription. Hope it will help you. Thanks. Take care. Dr Ishu Bishnoi