From the Guidelines
The vestibular system, which includes the inner ear and vestibular pathways in the brain, is the primary system responsible for controlling balance. The brain's ability to maintain balance is a complex process that involves the coordination of multiple systems, including the vestibular system, the visual system, and the proprioceptive system 1. The vestibular system, in particular, plays a crucial role in maintaining balance and posture by detecting changes in head position and movement 1.
Key Components of Balance Control
- The inner ear, which contains fluid-filled canals that detect head movements and position
- The vestibular pathways in the brain, which process information from the inner ear and send commands to muscles throughout the body to make the necessary adjustments to maintain balance
- The cerebellum, which coordinates movements and maintains equilibrium by processing sensory information from the inner ear, eyes, muscles, and joints
- The brainstem, particularly structures like the vestibular nuclei, which play a supporting role in balance control by relaying information between the cerebellum and spinal cord
How Balance Control Works
When you move your head, the fluid in the inner ear shifts, stimulating hair cells that send signals to the brain 1. The brain then processes this information and sends commands to muscles throughout your body to make the necessary adjustments to maintain balance 1. This complex system allows humans to stand upright, walk, run, and perform coordinated movements without falling over, even when the body's position changes rapidly.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Brain Structure Responsible for Balance
The part of the brain that controls balance is the cerebellum.
- The cerebellum is involved in motor and non-motor functions, including balance and vestibular control 2, 3.
- It has a large network of neurons that communicate with several brain structures and participate in different functions, including sensorimotor and vestibular control 2.
- The cerebellum maintains behavior around a homeostatic baseline, automatically, without conscious awareness, informed by implicit learning, and performed according to context 3.
Vestibular Function and Balance
Vestibular function is closely related to balance, and the cerebellum plays a key role in this process.
- The vestibular system is responsible for detecting changes in head position and movement, and the cerebellum processes this information to maintain balance 4, 5.
- Lesions in the cerebellum can lead to cerebellar vestibular syndrome, which is characterized by deficits in balance and vestibular function 3.
- The cerebellum is also involved in the modulation of distributed networks subserving multiple different functions, including balance and vestibular control 3.
Diagnostic Assessment and Treatment
Diagnostic assessment and treatment of balance disorders often involve evaluation of cerebellar function.
- Patients with cerebellar dizziness and vertigo usually show a pattern of deficits in smooth pursuit, gaze-holding, saccade accuracy, or fixation-suppression of the vestibulo-ocular reflex 5.
- Posturography and gait analysis can contribute to diagnostic differentiation, estimation of the risk of falls, as well as quantification of progression and treatment effects 5.
- Patients with cerebellar dizziness and vertigo should receive multimodal treatment, including balance training, occupational therapy, and medication 5.