Laine Waggoner, MA, MS
WHAT IT IS:
balance disorder- a disturbance of sensory input from the inner ear caused by
disturbance of central processing of balance signals to the brain. Can arise
from a disturbance of outgoing signals to eye muscles or muscles of position and
spinning, dizziness, floating, light headedness, wooziness, loss of balance,
falling or feeling of falling, visual blurring, disorientation. BPV causes
brief, intense spinning when changing positions.
PART OF EAR AFFECTED:
inner ear - the vestibule and semi-circular canals maintain balance (or not) -
small crystals from the gelatinous wall loosen and move freely in the inner ear
fluid. Vestibular system works with the visual system to keep objects in focus.
PROGRESSIONS - CAUSES & Types:
Benign Paroxysmal Positional Vertigo (or BPV) from the inner ear. Usually
acute and episodic. Damage to sensory units of inner ear & semi-circular
canals. Head trauma or ear infection cause 15-50% of cases.
Labrinthitis -Disturbance in labyrinth (PVD)-, central vestibular disorder
(in brain or connecting nerves), systemic disorder (elsewhere in the body,
vascular (blood flow) problems.
neuronitis- abrupt sustained vertigo lasting 1-7 days. 25-50% are associated
with fever and respiratory tract virus. Hearing loss may be absent.
fistula- leakage of inner ear fluid into the middle ear. Blood flow problems
include changes in blood pressure, diabetes, high blood fats, poor cardiac
function or anemia. Too much nicotine,
caffeine, salt or arterial tension. Medications can contribute to a balance
disorder. Allergies to certain foods or airborne particles.
disease- balance problem, tinnitus plus ear fullness. 3 Diagnostic groups: PVD
- episodic and abrupt peripheral vestibular disorder, psychiatric
causes, multiple sensory deficits. In older patients 23% may be caused by
central vestibular disorder of the brainstem or a cerebellum ischemia
IMPACT ON HEARING:
& degree of loss – I find no mention of hearing loss in my literature. We know
that inner ear infections can cause sensorineural hearing loss.
MOST AFFECTED POPULATION:
per year see doctor for dizziness or at least 1% of general population. Of over
60 age group,
20% have severe enough dizziness to affect their daily activities.
Avoid rapid changes in position or extremes of head motion. Decrease use of
foods/products that impair blood circulation. Minimize stress and anxiety. Avoid
driving, climbing ladders, or operating dangerous machinery when dizzy. For
motion sickness - take medicine (Dramamine, Bonine, Marezine) before traveling,
don’t read or face backward, avoid greasy, spicy foods.
Epley particle repositioning maneuver can clear acute symptoms, but 50% have
Current treatments for inner ear vertigo: Medicine can suppress nausea and
reduce vertigo but rarely cure
dizziness. Much prescribed - meclizine. Surgery may be treat or cure an
underlying ear disorder, i.e. mastoid surgery to treat chronic ear infections,
or to disable ear’s balance signals. Physical therapy- vestibular rehab. Or
balance retraining, may include sensory substitution to teach a person to
information from damaged parts of the system (i.e. inner ear) and to pay
attention to visual cues of spatial orientation to maintain balance. New
treatments are currently being researched. Meniere’s may be treated with diet
changes and antibiotics.
American Academy of Otolaryngology, Dizziness and Motion Sickness.
McGee, Steven. Dizzy Patients, Diagnosis & Treatment. Dept. of
Medicine, Univ. of Washington School of Medicine, Seattle WA. Western
Journal of Medicine 1995 (162:37-42)
National Institute on Deafness & other Communication Disorders.
VEDA, Vestibular Disorders Assn. For brochures:
Wall, Conrad & Rausch, Steven: New Help for Dizzy Patients; Hearing
Health Magazine, Summer 2006.(pp.28-31),
Waggoner is the Director of HEAR (Hearing-loss
Education And Relationships), which conducts support
groups, facilitates seminars, and provides private coaching for individuals who
are experiencing hearing loss. Email:
Member of the Gallaudet University Peer Mentoring Certificate Program.
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