Disequilibrium causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vendhan Ramanujam M.B.B.S [2]


Disequilibrium is the result of a dysfunction at one or more points in the complex system required for balance and ambulation. Disequilibrium may be caused by abnormalities in the visual, motor, sensory, cerebellar and vestibular systems.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Acute coronary syndrome, arrhythmia, arteriosclerosis, cardiomyopathy, congestive heart failure, dehydration, hypertension, hypotension, microscopic polyangiitis, myocardial infarction, postural hypotension, transient ischaemic attack, vasculitis, vertebral artery dissection
Chemical/Poisoning Acrylamide, arsenic, heavy metals, konzo, lead, mercury, methanol, organophosphates, salicylate poisoning
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Aminophylline, amiodarone, amphotericin B, antihypertensives, antibiotics, anticholinergics, anticonvulsants, antidepressants, aspirin, aurothioglucose, biguanide, bortezomib, capecitabine, carbachol, carbon tetrachloride, celecoxib, chlorpheniramine, cinnarizine, cisplatin, clomifene, colchicine, dapsone, diphenhydramine, disulfiram, diuretics, ethambutol, ethotoin, fluorouracil, hydralazine, hydroxyzine, isoniazid, ixabepilone, lamivudine, leflunomide, linezolid, lithium, mefloquine, melarsoprol, metronidazole, nalidixic acid , neuroleptics, nitrofurantoin, nortriptyline, nucleoside analogues, oxaliplatin, paclitaxel, phenylbutazone, phenytoin, physostigmine, prochlorperazine, pyridoxine, rofecoxib, sedatives, stavudine, suramin, taxol, thallium, toluene, trabectedin, tranquilizers, vaccines, verteporfin, vigabatrin, vincristine
Ear Nose Throat Hearing impairment
Endocrine Acromegaly, diabetes mellitus, diabetic amyotrophy, diabetic ketoacidosis, diabetic radiculopathy, hyperthyroidism, hypoparathyroidism, hypothyroidism, phaeochromocytoma
Environmental Altitude sickness, cold exposure, electrical injury, heat stroke, lathyrism
Gastroenterologic Celiac disease, chronic liver disease, hepatic cirrhosis, intestinal fistula, primary biliary cirrhosis, pyloric stenosis, tropical sprue, viral hepatitis
Genetic 3-methylglutaconic aciduria, 4H syndrome, abetalipoproteinemia, adrenoleukodystrophy, adrenomyeloneuropathy, alpha-mannosidase deficiency, alpha-methylacyl-CoA racemase deficiency, argininosuccinic aciduria, arylsulphatase A deficiency, aspartoacylase deficiency, ataxia-telangiectasia, ATP6V0A2-related cutis laxa, bilateral frontoparietal polymicrogyria, biotinidase deficiency, carbamoylphosphate synthetase deficiency, carbohydrate deficient glycoprotein syndrome type 1a, Charlevoix-Saguenay spastic ataxia, Cockayne syndrome, coenzyme Q10 deficiency, De Grouchy Syndrome, dentatorubral-pallidoluysian atrophy, Fabry's disease, familial alphalipoprotein deficiency, Friedreich's ataxia, Gamstorp-Wohlfart syndrome, glucose phosphate isomerase deficiency, GM2 gangliosidosis, Griscelli syndrome, Haw river syndrome, hereditary neuralgic amyotrophy, Huntington disease, hypobetalipoproteinemia, Joubert syndrome, Loken Senior syndrome, Marinesco-Sjogren syndrome, MELAS, MERRF, MPV17 gene mutation, multiple carboxylase deficiency, phenylalanine hydroxylase deficiency, progressive external ophthalmoplegia, Refsum disease, Roussy-Levy disease, Sandhoff disease, SeSAME syndrome, Silver syndrome, Troyer syndrome, Unverricht-Lundborg disease, Van der Knaap disease, Von Hippel-Lindau syndrome
Hematologic Anemia, glucose phosphate isomerase deficiency, haemochromatosis, leukemia, multiple myeloma, pernicious anemia, plasmacytoma, polycythemia vera, sideroblastic anemia
Iatrogenic No underlying causes
Infectious Disease Acute necrotizing myelopathy, acute viral myelitis, borrelia burgdorferi, botulism, brainstem encephalitis, brucellosis, cerebellar abscess, chickenpox, coxsackie A virus, cysticercosis, cytomegalovirus polyradiculopathy, diphtheria, encephalomyelitis, endophthalmitis, epidural abscess, epstein-barr virus, Guillain-Barré syndrome, herpes simplex, herpes zoster, HIV, leprosy, lyme disease, malaria, meningoencephalitis, mycoplasma pneumoniae, ophthalmia neonatorum, osteomyelitis, polymyositis, schistosoma, septic arthritis, septicemia, syphilis, tick paralysis, transient synovitis, treponema pallidum, tuberculosis, typhoid fever, viral hepatitis
Musculoskeletal/Orthopedic Carpal tunnel syndrome, Charcot-Marie-Tooth disease, chondroma, compartment syndrome, connective tissue disease, dermatomyositis, Duchenne muscular dystrophy, Ewing's sarcoma, femoral neuropathy, hereditary neuralgic amyotrophy, herniated vertebral disc, leg fractures, muscle weakness, osteoarthritis, osteochondroma, osteoma, osteomyelitis, osteosarcoma, Pagets disease, peroneal compression at the fibular neck, Perthes disease, septic arthritis, slipped upper femoral epiphysis, tarsal tunnel syndrome, transient synovitis
Neurologic Acoustic neuroma, acute necrotizing myelopathy, acute viral myelitis, alcoholic polyneuropathy, amyotrophic lateral sclerosis, anti-glutamic acid decarboxylase associated cerebellar ataxia, Arnold-Chiari malformation, ataxia-oculomotor apraxia, basilar migraine, benign paroxysmal vertigo, brainstem encephalitis, carotid-cavernous fistula, cerebellar abscess, cerebellar hypoplasia, cerebellar ataxia, cerebellar dyssynergia, cerebellar hemorrhage, cerebellar tumor, cerebellar vermis agenesis, cerebral palsy, cerebrotendineous xanthomatosis, cerebrovascular disease, ceroid lipofuscinosis, cervical spondylosis, cockayne syndrome, confusional state, copper deficiency myeloneuropathy, cortical visual impairment, Creutzfeldt-Jakob disease, cytomegalovirus polyradiculopathy, Dandy-Walker syndrome, deafferentation, decompression sickness myelopathy, Dejerine Sottas syndrome, dementia, demyelination, diabetic amyotrophy, diabetic radiculopathy, diffuse sclerosis of Schilder, distal hereditary neuronopathy, dural arteriovenous fistula, dyssynergia cerebellaris myoclonica, encephalocele, encephalomyelitis, epidural abscess, epilepsy, episodic ataxia, familial Danish dementia, familial hemiplegic migraine, fetal akinesia-hypokinesia sequence, Friedreich's ataxia, Gerstmann-Sträussler-Scheinker syndrome, giant axonal neuropathy, Haw River syndrome, hereditary amyloid polyneuropathy, hereditary ataxia, hereditary sensory and autonomic neuropathy, hereditary spastic paraplegia, Herniated vertebral disc, hypoxia, idiopathic lumbosacral radiculoplexus neuropathy, idiopathic small fiber neuropathy, intracranial space-occupying lesion, Kearns-Sayre syndrome, Klumpke paralysis, lathyrism, Leigh syndrome, lower motor neuron weakness, lumbosacral plexitis, Machado-Joseph disease, meningoencephalitis, meralgia paresthetica, migraine, mitochondrial ataxia, multifocal motor neuropathy, multiple lentigines syndrome, multiple sclerosis, multiple sensory defect dizziness, multiple system atrophy syndromes, myasthenia gravis, myelopathy, NARP syndrome, neurofibromatosis, normal pressure hydrocephalus, Nothnagel Claude syndrome, obturator neuropathy, olivopontocerebellar atrophy, orthostatic myoclonus, pantothenate kinase, paraneoplastic cerebellar degeneration, paraneoplastic sensory neuropathy, Parkinson disease, Pelizaeus-Merzbacher disease, peripheral neuropathy, polyrediculitis, posterior inferior cerebellar artery syndrome, posterior leucoencephalopathy syndrome, raised intracranial pressure, Sandhoff disease, sciatic neuropathy, spinal arteriovenous malformations, spinal cord tumor, spinal epidural hematoma, spinocerebellar ataxia, stroke, subacute combined degeneration, subacute necrotising encephalomyelopathy, subacute sensory neuronopathy, superior orbital fissure syndrome, syringobulbia, syringomyelia, transient ischaemic attack, transverse myelitis, Unverricht-Lundborg disease, upper motor neuron weakness, urination, Van der Knaap disease, vasculitis, vasovagal attacks, vestibular disorder
Nutritional/Metabolic 2-hydroxyglutarate dehydrogenase deficiency, acute intermittent porphyria, alpha-mannosidase deficiency, alpha-methylacyl-CoA racemase deficiency, argininosuccinic aciduria, arylsulphatase A deficiency, aspartoacylase deficiency, beri-beri, carbamoylphosphate synthetase deficiency, carbohydrate deficient glycoprotein syndrome type 1a, Chester porphyria, citrullinemia, cytosine arabinoside, erythropoietic protoporphyria, GM2 gangliosidosis, Hartnup disease, homocitrullinuria syndrome, hypobetalipoproteinemia, hypocalcemia, hypoglycemia, hyponatremia, isovaleric acidemia, Lesch-Nyhan syndrome, Maple syrup urine disease, metabolic acidosis, multiple carboxylase deficiency, nutritional amblyopia, ornithine transcarbamylase deficiency, phenylalanine hydroxylase deficiency, porphyria, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, Strachan syndrome, uremia, Wilson disease
Obstetric/Gynecologic Childbirth, menopause, pregnancy
Oncologic Acoustic neuroma, cerebellar tumors, chondroma, Ewing's sarcoma, Hodgkin's lymphoma, lung carcinoma, neuroblastoma, neurofibromatosis type 1, non-Hodgkin's lymphoma, osteochondroma, osteoma, osteosarcoma, paraneoplastic syndrome, rhabdomyosarcoma, plasmacytoma, spinal cord tumor
Ophthalmologic Cataract, central serous chorioretinopathy, cortical visual impairment, endophthalmitis, Hoyeraal-Hreidarsson syndrome, hyphema, Miller-Fisher syndrome, ocular ischemic syndrome, ophthalmia neonatorum, progressive external ophthalmoplegia, retinal degeneration, retrolental fibroplasia, visual impairment, vitreous hemorrhage
Overdose/Toxicity Alcohol toxicity
Psychiatric No underlying causes
Pulmonary Asthma exacerbation, chronic obstructive pulmonary disease exacerbation, diffuse pulmonary fibrosis, pleural effusion, pneumonia, pneumothorax, pulmonary edema, pulmonary embolism
Renal/Electrolyte Renal failure
Rheumatology/Immunology/Allergy Acute demyelinating encephalomyelitis, ankylosing spondylitis, antiphospholipid antibody syndrome, benign monoclonal gammopathy, connective tissue disease, dermatomyositis, fibromyalgia, gout, Guillain-Barré syndrome, lymphomatoid granulomatosis, microscopic polyangiitis, mixed connective tissue disease, monoclonal gammopathy, polyarteritis nodosa, pseudogout, Reiter's syndrome, rheumatoid arthritis, scleroderma, seronegative spondyloarthritis, Sjögren's syndrome, systemic lupus erythematosus
Sexual No underlying causes
Trauma Cerebellar hemorrhage, head injury, leg fractures
Urologic No underlying causes
Miscellaneous Amyloidosis, cryoglobulinemia, drop attack, dysproteinemia, emotions, generalized weakness, hyperventilation, metachromatic leukodystrophy, multiple hamartoma syndrome, Niemann-Pick disease, old age, pain, paraproteinemia, Salla disease, sarcoidosis, Shy-Drager syndrome, sialidosis, Tay-Sachs disease

Causes in Alphabetical Order


  1. Sturnieks, DL.; St George, R.; Lord, SR. (2008). "Balance disorders in the elderly". Neurophysiol Clin. 38 (6): 467–78. doi:10.1016/j.neucli.2008.09.001. PMID 19026966. Unknown parameter |month= ignored (help)
  2. Kroenke, K.; Lucas, CA.; Rosenberg, ML.; Scherokman, B.; Herbers, JE.; Wehrle, PA.; Boggi, JO. (1992). "Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care". Ann Intern Med. 117 (11): 898–904. PMID 1443950. Unknown parameter |month= ignored (help)
  3. Cherchi, M. (2011). "Infrequent causes of disequilibrium in the adult". Otolaryngol Clin North Am. 44 (2): 405–14, ix. doi:10.1016/j.otc.2011.01.011. PMID 21474014. Unknown parameter |month= ignored (help)

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