VERTIGO

by Laine Waggoner, MA, MS

WHAT IT IS:

A 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 gait.

SYMPTOMS:

Room 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: 

Usually the 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:

  • BPPV- 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.

  • Vestibular neuronitis- abrupt sustained vertigo lasting 1-7 days. 25-50% are associated with fever and respiratory tract virus. Hearing loss may be absent.

  • Perilymph 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.

  • Meniere’s 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:

Type & 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:

Two million 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.

PREVENTATIVE TREATMENT:
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.

REHAB TREATMENT:
Epley particle repositioning maneuver can clear acute symptoms, but 50% have relapses.
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 neglect faulty
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.

REFERENCES:

American Academy of Otolaryngology, Dizziness and Motion Sickness.
www.entnet.org/healthinfo/balance/dizziness.cfm, 7/5/06

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.
Balance Disorders.
www.nidcd.nih.gov/health/balance/balance_disorders.asp 7/5/06

VEDA, Vestibular Disorders Assn. For brochures: veda@vestibular.org
Web: https://vestibular.org

Wall, Conrad & Rausch, Steven: New Help for Dizzy Patients; Hearing
Health Magazine, Summer 2006.(pp.28-31), www.drf.org
 

Laine 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: LaineWaggoner@dc.rr.com 

Member of the Gallaudet University Peer Mentoring Certificate Program.


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