Balance (Vestibular) Disorders

small child concentrating

Kids stumble and fall sometimes, especially toddlers. However, if you're seeing a pattern of possibly balance-related symptoms (dizziness, falling, blurred vision, disorientation or nausea) — find out what's going on. The Nemours Balance Disorders Program provides a unique and effective way to evaluate, diagnose and care for children with balance and vestibular (inner ear balance) disorders.

 
Read More About Vestibular Disorders

In our state-of-the art center for pediatric vestibular testing we are able to perform specialized testing in labs where we can stimulate the inner ear and see how balance and gross motor skills (that is, movement of the large muscles) are affected. We believe that our comprehensive approach has allowed us a high rate of success in identifying and managing children with a variety of vestibular disorders.

A balance disorder may be caused by the pathology (problem) of the labyrinth, which is an organ of the body located in the inner ear, consisting of three semicircular canals and the vestibule. The labyrinth interacts with the eyes, muscles, and joints to maintain the body’s position. This system, along with the brain and the nervous system, can be the source of balance disorders.

Balance disorders can be traced to four key areas:
  • Peripheral vestibular disorder, a disturbance in the vestibule
  • Central vestibular disorder, a problem in the brain or its connecting nerves
  • Systemic disorder, a problem in the body other than the head and brain
  • Vascular disorder or blood flow problems

Nemours Children's Hospital, Orlando


13535 Nemours Parkway
Orlando, FL 32827
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For Appointments: (407) 650-7715
Hours: Monday–Friday, 8 a.m. to 5 p.m.

 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
  • prior audiology, otolaryngology and/or screening reports
New Patients

Bring these forms for your first appointment:

Returning Patients
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
 
Forms & Resources
New Patient Forms
Returning Patient Forms
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families

The pediatric specialists at Nemours Children’s Hospital in Orlando use state-of-the-art technology and the latest testing techniques to evaluate, diagnose and treat children with balance and vestibular (inner ear balance) problems. To better serve children and families throughout Central Florida, many of our otolaryngologists (ear, nose and throat, "ENT" specialists), neurotologists and audiologists (hearing) specialists also see kids at our specialty care locations in downtown Orlando, Lake Mary and Melbourne

Learn More About Pediatric Otolaryngology Services at Nemours Children’s Hospital »

Multispecialty Pediatric Care for Balance (Vestibular) Disorders

Our bodies rely on three separate systems for balance: neurological (the nervous system), auditory (hearing) and vestibular (balance). 

To pinpoint the cause of your child’s balance problems, our board-certified otolaryngologists work closely with other internationally recognized Nemours specialists. Once they find the cause, they customize an effective treatment to improve your child’s comfort and quality of life.

 
Types of Balance Disorders We Treat

The most frequently diagnosed vestibular conditions include:

  • benign paroxysmal torticollis of infancy (condition marked by a tilted head from feeling dizzy)
  • benign paroxysmal vertigo of childhood, or "BPV"(sometimes called childhood paroxysmal vertigo caused by fluid or tiny particle build-up in the inner ear)
  • vestibular neuritis (an infection that causes inflammation of the vestibular nerve)
  • labyrinthitis (can be caused by an infection of the part of the inner ear, the labyrinth, that controls balance)

Other balance problems include:

  • ototoxicity (caused by medications that destroy the hair cells in the inner ear responsible for sending balance signals to the brain)
  • Ménièr disease (caused by an imbalance of inner ear fluid)
  • peripheral disorders (such as perilymph fistula and enlarged vestibular aqueduct syndrome)
 
Your Child’s Balance Disorder Care Team

In addition to pediatric otolaryngologists, neurotologists, otologists and audiologists, Nemours balance disorder care teams may also include:

Balance Disorder Signs and Symptoms in Children

Kids with balance disorders often feel unsteady or "woozy," which makes it hard to stand up, walk or turn corners. They may also:

  • have trouble climbing stairs without falling
  • bump into things, stumble or trip
  • walk with their legs too far apart
  • stagger when walking
 
Common Symptoms of Vestibular Disorders

Symptoms of a balance problem may include:

  • vertigo (a rocking, floating or "on a merry-go-round" feeling, and/or feelings of dizziness, lightheadedness or disorientation)
  • oscillopsia (vision disturbances like bouncing or blurriness, difficulty reading and writing)
  • nystagmus (involuntary eye movements)
  • hearing problems (muffled sounds, ear pain, ear pressure or "fullness", ringing in the ear)
  • discomfort or difficulty looking at sun glare or lights, especially fluorescent, flashing or moving lights
  • discomfort in situations with "busy" visuals like patterns, crowds, heavy traffic and jam-packed areas like shopping malls
  • trouble with depth perception and disruptions that can affect hand-eye or eye-foot coordination (which can make it hard to do things like catch or kick a ball)

Nemours Children’s Hospital specializes in providing unique and effective way to evaluate, diagnose and care for children with balance or vestibular disorders.

 
Causes of Balance Problems in Kids

Balance-related symptoms may be brought on by any number of things, such as:

  • ear, head or neck injuries
  • migraines
  • hearing loss
  • immune-deficiency disorders
  • metabolic disorders
  • neurological disorders
  • vascular insufficiencies
  • chronic middle ear infections (otitis media)
  • other infections (cold, flu, meningitis, measles, mumps or rubella)
  • depression
  • motion sickness or sensitivity
  • seizure disorders

Children who have a family history of hearing or vestibular problems, dizziness or motion sickness might also be more prone to balance disorders.

 
The Relationship Between Balance and Hearing

The ear houses both an auditory system (for hearing) and a vestibular system (for balance). These two systems, which are about the size of a dime, are connected. If a problem occurs in one area, it may also affect the other.

In some kids, a balance problem may lead to hearing loss (either temporary or permanent). And in others, hearing loss may be recognized first and then a balance problem may be discovered. Studies show that up to 30 percent of children with permanent hearing loss may also experience a balance problem, and about 10 percent of kids with a vestibular problem also have hearing loss.

Learn More About These and Other Children’s Health Topics at Nemours KidsHealth.org »

Diagnosing Balance Disorders in Children

Balance problems in children are difficult to diagnose because the symptoms often go unnoticed or are mistaken for typical childhood behavior. At Nemours Children’s Hospital, our collaborative team uses the latest equipment and evaluation methods to diagnose vestibular disorders of all kinds. Our licensed specialists have extensive experience working with children of all ages with special needs.

In addition to basic hearing tests, we conduct auditory balance testing in a lab where we can stimulate the inner ear to see how your child’s balance is affected. Testing is customized to your child’s age and developmental abilities. Medical imaging tests such as MRI, CT or "CAT" scans may also be ordered.

Comprehensive vestibular testing is scheduled as a panel appointment — this means your child will receive evaluations in otolaryngology, audiology and other specialists on the same day. The entire vestibular evaluation will last about five to six hours, with many breaks throughout.

Treating Pediatric Balance (Vestibular) Disorders

Treating balance disorders can help kids function and feel better. There are many management options for treating balance disorders in children, and they vary depending on the underlying cause of the symptoms. Every child is unique, and our main goal is to maximize your child’s ability to fully and comfortably participate in activities of daily living.

 
Treatment Options for Balance Disorders in Children

Depending on your child’s condition, we may recommend:

  • dietary changes
  • medications (anti-nausea drugs, antibiotics, corticosteroids)
  • vestibular rehabilitation therapy or "VRT" (exercises that help with balance, reflexes, eye movement control, etc.)
  • surgery 

A Hospital Designed by Families, for Families

At Nemours Children’s Hospital, family-centered care is at the heart of everything we do. In fact, families helped shape the unique amenities and convenient services that make our hospital like no other in the region.

 
If Your Child Needs to Stay Overnight in Our Hospital

You’ll feel right at home in one of our private patient rooms designed with input from families who know what it’s like to have a child in the hospital.

Our large, comfortable, single-patient rooms have sleeping accommodations for two parents, a private bathroom, wireless Internet access, connections for DVD players and game systems, and two flat-screen TVs.

Other in-room features include:
  • full floor-to-ceiling windows for natural light
  • refrigerator for family meals and snacks
  • wardrobe storage for personal items and a hotel-style safe
  • GetWellNetwork interactive television (uniquely based on your child’s age, medical condition and more) and allows your child to watch TV, surf the Web, check e-mail, play music and games, and learn about your Nemours health care team.

Our “hospital within a garden” setting features many places for you and your family to go for fresh air and relaxation, including a one-acre interactive sensory discovery garden or one of our rooftop gardens on the second and fourth floors.

We have many more comforts and amenities such as:
  • complimentary valet and parking
  • kid-friendly commons areas for siblings
  • café and coffee shop
  • nondenominational chapel
  • concierge services

Learn More About Nemours Children’s Hospital »

 
Advanced Pediatric Medical Imaging Services Available Onsite

If your child needs medical imaging, we offer some of the area’s most advanced pediatric radiology services here on campus at Nemours
Children’s Hospital.

Our unique services include:
  • interventional radiology: Our team of experts uses image guidance to diagnose and treat diseases and tumors throughout the body. Certain conditions that previously required open surgery can now be treated by Nemours pediatric interventional radiologists. We are very fortunate to have the only dual-trained pediatric diagnostic and interventional radiologist in the state.
  • neuroradiological or cardiovascular imaging, and fetal MRI (magnetic resonance imaging): Our subspecialty-trained pediatric radiologists see children with complex conditions who require this highly specialized imaging.
  • Central Florida’s only 256-slice Brilliance iCT Scanner: We are one of only a handful of children’s hospitals in the country to have this latest generation CAT (or CT) scanner that scans faster than most machines and produces excellent images in a much shorter time with much less radiation exposure for the child.

Our team of board-certified pediatric radiologists and pediatric radiologic technologists are experts in the safe medical imaging of children of every age, even newborns.

We have also pledged our commitment to the “Image Gently” campaign of the Alliance for Radiation Safety in Pediatric Imaging, which is increasing awareness of the opportunities to promote radiation protection in the imaging of children.

Learn More About Medical Imaging at Nemours Children's Hospital »

 
Family-Centered Care Means We're Here for You

At Nemours, we want to hear your concerns and share with you everything we can about your child's condition and treatment. If English is not your first language, we'll make sure you understand what to expect — in your language.

Learn More About Interpreter Services at Nemours Children’s Hospital »

 
With Your Family From Clinic or Hospital to Home: KidsTRACK

If your child has a complex or chronic condition we encourage you to take advantage of KidsTRACK, a unique service of Nemours Children’s Hospital. Located on the first floor of our hospital, KidsTRACK is designed to help families by providing expert assistance and information on all aspects of your child’s care, even before you leave our hospital or clinic.

A KidsTRACK care coordinator is available during every step of diagnosis, treatment and healing — helping your family make a smooth transition from Nemours Children's Hospital to home. Your coordinator works alongside the nursing/case managers in our subspecialty areas and acts as a single point of contact connecting you to medical and community resources.

Simply ask your physician for a referral to KidsTRACK
or call (407) 650-7715.

Learn More About KidsTRACK at Nemours Children's Hospital »