Information: about Vestibular Disorders

Vestibular Disorders: Includes Dizziness, Inner Ear Disorders and Meniere's Syndrome.

New Horizons Un-limited is not endorsing and assumes no responsibility in guaranteeing the products, services, programs or conditions as described. If you are interested in a resource listed below, call or contact the resource to verify the current situation. Evaluate the information, analyze your unique circumstances, use your best judgment and make your own decisions when using the information. Before making any change, consult your health care professional.
Quick link to the information of your choice on Vestibular Disorders:

What are Vestibular Disorders?

  • Vestibular Disorders are inner ear disorders that may cause imbalance, vertigo, dizziness, tinnitus, and hearing loss.

  • Glossary by the Vestibular Disorders Association offers definitions of terms used in describing vestibular disorders.

Various Vestibular Disorders

There are many types of Vestibular Disorders. The Vestibular Disorders Association (VEDA) is an international organization based in Portland, Oregon that offers information and support for people suffering from inner ear disorders that cause dizziness, nausea, and balance problems. They list the following specific vestibular disorders including the different causes, characteristics, diagnostic tests and treatments for each disorder. This website would be a good start to find a good overview and information regarding each of the following disorders.

  • Benign Paroxysmal Positional Vertigo (BPPV)

  • Meniere's Disease (idiopathic (unknown cause) endolymphatic hydrops)

  • Secondary Endolymphatic Hydrops

  • Labyrinthitis & Vestibular Neuritis

  • Perilymph Fistula

  • Acoustic Neuroma

  • Ototoxicity

  • Vestibular Migraine

  • Mal de Debarquement

  • Pediatric Vestibular Disorders

  • Aging, Dizziness, & Balance

  • Cervicogenic Dizziness

  • Otosclerosis

  • Cholesteatoma

  • Enlarged Vestibular Aqueduct

  • Vestibular Hyperacusis

  • Autoimmune Inner Ear Disease

  • Superior Canal Dehiscence

Many of these disorders are complex because of their effect on the inner ear, which is partially responsible for our sense of balance, as well as to hearing. This effect may vary in severity, scope and duration. These Inner Ear Disorders or Vestibular Disorders that affect our sense of balance can be very disabling causing pressure or fullness in the ear, tinnitus (ringing or roaring), severe imbalance or vertigo (causing the person to fall, have nausea or vomit) or hearing loss. Some have unknown causes, are difficult to diagnosis, with diagnosis through exclusion by various otological and neurological tests, and are not curable. Discuss all treatment possibilities with doctors specializing in these disorders and seek second opinions. Treatments have been successful, but not necessarily in all patients. Always ask your doctor and/or pharmacist of side effects or risks.

What are the causes of Vestibular Disorders?

  • Aging - degeneration of the hair cells in the inner ear.
  • Trauma/accident to the inner ear, for example: via head injury from an auto accident.
  • Sudden change in pressure or sound.
  • Surgery.
  • Developmental or congenital abnormality.
  • Poor circulation - low blood pressure to the brain or hardening of the arteries.
  • Bacterial or Viral Infection.
  • Diseases that affect the Inner Ear.
  • Tumors.
  • Ototoxicity refers to the damage caused to the inner ear (labyrinth) from the use of various medications. These medications can damage the inner ear's balance (vestibular) system or hearing (auditory) system or both.
  • Fluid leaking from the inner ear through a hole.
  • Particulate matter floating in the inner ear.
  • Inflamation of the Inner Ear.
  • Change in the volume of fluid inside a portion of the inner ear called the labyrinth, which includes the membranous labyrinth and the bony labryinth.
  • Other - Sometimes the cause of a Vestibular Disorder can be unclear or unknown.

What are the characteristics of Vestibular Disorders?

The Vestibular Disorders Association (VEDA) lists the following possible symptoms people with Vestibular Disorders may experience. See their comprehensive list under "Symptoms" on their website.

  • Vertigo and dizziness - Everyone has at some time experienced dizziness in the forms of light-headedness, vertigo, imbalance, or fainting. Most causes of vertigo (a type of dizziness) are due to a problem with the inner ear or specifically, the vestibular system.

  • Balance and spatial orientation - People with Vestibular disorders may experience imbalance, stumbling and falling. When the brain is not getting good information from the inner ear about the body's balance and spatial orientation, the person must begin to depend on vision and the walking surface to orient the body's balance and place in space.

  • Vision - busy surfaces, lights, etc. can confuse the person with a Vestibular Disorder as they are now relying on their vision to give the brain clues on balance. This confusion can lead to dizziness and nausea.

  • Hearing - Vestibular Disorders may cause hearing loss. Another major symptom is Tinnitus, the ringing, buzzing, clicking sounds in the ear. This can lead to sensitivity to sudden or loud sounds.

  • Cognitive and psychological - Anxiety and mental fatigue occurs when dealing with the symptoms of this disorder which can lead to depression. People with loss of hearing or tinnitus, lose out on pieces of conversation, can become confused easily by what is happening, or what is being said. Loss of control of one's balance can lead to loss of self reliance, self-esteem etc.

  • Other - Dizziness can lead to nausea and vomiting. Some people may experience ear pain or headaches.

What are the statistics regarding Vestibular Disorders?

  • There are no official statistics about vestibular disorders. The difficulties in diagnosing and classifying these disorders make it difficult to collect accurate information about vestibular disorders and the extent of vestibular disorders in the general population.

  • VEDA (Vestibular Disorders Association) has collected some statistical information from a variety of sources. The VEDA page on statistics reports that VEDA, itself, averaged about 65,000 requests per month for information in 2005, up from 50,000 in 2003. They also report from other studies that more than 90 million Americans have had problems with dizziness or balance, that around 30% of people over 60 have experienced dizziness, that 10% of people with dizziness or balance problems experienced severe disability, and that at least 20% of the people diagnosed with a vestibular disorder were diagnosed with BPPV. Other common conditions include Meniere's Disease, labyrinthitis, and endolymphatic hydrops. To see more statistical information about vestibular disorders and a list of sources for the information presented go to the link listed above.

Prevention

  • Use safety equipment and safe practices when using factory, farm, or power tools.
  • Protect the ears when using equipment of any kind that causes great change in pressure or sound.
  • Become aware and be cautious taking the type of medications that can have a damaging affect on the inner ear, use other equally effective drugs if they are available. For more information, go to this article that Merck & Co., Inc., a global research-driven pharmaceutical company, has published on Drug-Induced Ototoxicity that discusses the medications that can cause damage to the inner ear.
  • Mayo Clinic - Simple Tips to Prevent Falling People with Vestibular Disorders must take extra precautions to prevent falling. Vestibular Disorders can cause dizziness and/or vertigo which affects balance and mobility. The link above will take you to an article for six simple fall-prevention strategies.

Awareness

  • Become aware of the triggers that can bring on a vertigo or an imbalance incident.

  • Become aware of the affect on daily activities.

  • People First Language from disabilityisnatural.com by Kathie Snow offers insight into society's use of language when using the term disability. The term disability is a societal construct to identify characteristics related to a medical condition that may entitle an individual for services or legal protections. The use of this language encourages freedom, respect and inclusion for all, and recognizes forms of language that can isolate, create negative stereotypes and place attitudinal barriers for individuals. "Using People First Language, putting the person before the disability—and eliminating old, prejudicial, and hurtful descriptors, can move us in a new direction. People First Language is not political correctness; instead, it demonstrates good manners, respect, the Golden Rule, and more—it can change the way we see a person, and it can change the way a person sees themself!" For more articles by Kathie Snow to "help us begin to use more respectful and accurate language and create positive change," visit People First Language and More

Viewpoint

  • Often at first the person may see many doctors before the symptoms are clear enough to diagnose.
  • It is often not easy to describe the sensation one is feeling with Vestibular Disorders.
  • There are different triggers for people, some are similar.

On-Line Discussion

Needs and Solutions

  • Emergency and critical care management

  • Clinical diagnosis is critical. Patients need to be able to describe the sensation they are feeling, what triggered the dizziness event, the duration and severity of the attack.

  • Special tests of balance function, hearing tests, CAT scan, and MRI scan are some of the tests used to diagnose a balance disorder. Referral to an ear specialist or neurologist may be necessary. Some diagnostic methods used include a rotating chair and moving platform, testing equipment that is not available in the average ear doctor’s office.

  • If you did not find a clinic located near you at our page on Health and Care for Vestibular Disorders or if you want to see if there are other clinics in your area, the following websites list physicians and other health professionals located throughout the United States that specialize in diagnosing and treating vestibular disorders. The VEDA site also has lists for other parts of the world. The health professionals listed include physicians, physical therapists, and audiologists.

    • Vestibular Disorders Association (VEDA) Search By address page provides maps that will allow you to find a list of health professionals that specialize in treating vestibular disorders in all parts of the world. On the U.S. map, click on a state to find a list for that state. For other parts of the world, click on the appropriate map.

    • Patients with balance problems need to take proper precautions to avoid accidents that could be caused by their balance disorder. For instance, to prevent falls, provide clear egress through the home.

      Treatment and Rehabilitation

    • The goal of treatment and rehabilitation after a diagnosis is to help the patient return to the highest level of function and independence possible and to diminish the effect of the Vestibular incident, managing vertigo, reducing frequency of attacks and preserving hearing.

      In order to help reach the goals of treatment and rehabilitation, Vestibular Disorder treatments may include the following:

      • Medication
      • Eliminating alcohol, coffee and salt may help make attacks less frequent and eliminating tobacco and stress may make them less severe.
      • Surgery
      • Treatments to help improve mobility
      • Activities and training to help improve motor skills, restore activities of daily living (ADLs), and help the patient reach maximum independence
      • Vestibular Rehabilitation is an article on eMedicine by Philip E. Zapanta, MD, that describes the Special Exercises in Vestibular Rehabilitation Therapy that helps the patient to adjust or accommodate to the Vestibular condition. This article explains how important this therapy can be in managing vertigo after 2-3 months of onset and how important the therapy is in the treatment of Vestibular disorders.
      • Education
      • Diet is extremely important in the treatment of Meniere’s Disease and several other vestibular disorders. The following sites on the Internet will help you to understand your dietary requirements better and how to meet them. The VEDA page offers a good introduction to the diet and why its important. The Washington ENT chart offers a good supplement to the VEDA page and helps one figure out what you should and shouldn't eat as far as salt is concerned. Changing your diet may be difficult as it also may require a lifestyle change. Also, consult your health care professional before you begin.

        • Dietary Considerations is a page on the VEDA (Vestibular Disorders Association) website, that will explain why you need to restrict your salt and sugar intake and limit or avoid a variety of substances including caffeine, alcohol, and nicotine. VEDA also publishes a low-salt cookbook (B-6) for $17.95 and a short publication called “Dietary Considerations with Endolymphatic Hydrops, Meniere’s Disease, & Vestibular Migraine (S-17) for $4.00. An order form and list for ordering these publications can be found under “Publications and Membership” in the toolbar at the top of the page. For more information, send e-mail to: info@vestibular.org

        • New Sign Lifestyle and home remedies

          • is by the Mayo Clinic Staff and covers some recommendations for managing vertigo, salt intake and stress.

        • New Sign Treatment with dietary and lifestyle adjustments

          from the Meniere's Disease Information Center, Treatment of Meniere's Disease. Includes links to articles about salt intake, and other diet and lifestyle triggers and stress and the affect on Meniere's episodes.

        • Meniere's Disease, from the Midwest Ear Institute in Indianapolis, Indiana, scroll down to "Treatment" and this article covers the possible affects of sodium, caffeine, and alcohol on the inner ear. See also the article, "Sodium Content of Your Food", see below.

        • "Sodium Content of Your Food" is a link to an article from the website of the Midwest Ear Institute in Indianapolis, IN. It provides information about the sodium content of foods. It includes a table categorizing foods by high, medium, and low sodium content and another table listing the sodium content of various foods in mgs.

    Learn More about Vestibular Disorders

    To learn more about Vestibular Disorders, find other related resources by visiting the following informational websites.

    • emedicine-Neuro-otology is a website of medical information for doctors and other health professionals. The Neuro-otology pages have articles covering benign paroxysmal positional vertigo (BPPV); dizziness, vertigo and balance problems; endolymphatic hydrops including Meniere’s Disease; labyrinthitis; and syncope (fainting). The articles cover the nature, symptoms, and possible causes of a health condition; procedures for diagnosing and treating the condition; and information about the possible drugs that might be used to treat the condition. Although these pages are written for medical professionals, a lay person can learn quite a bit about a health condition and its treatment from reading these pages.

    • Do Balance Disorders Go Away? on Medicinenet.com, written by Medical Author: Divya Jacob, Pharm. D. Medical Reviewer: Pallavi Suyog Uttekar, MD

    • Vestibular Disorders Association (VEDA) is an international organization based in Portland, Oregon that offers information and support for people suffering from inner ear disorders that cause dizziness, nausea, and balance problems. VEDA publishes information about vestibular disorders and how to cope with them. VEDA has support groups located in the US, Canada, Europe, Australia, and New Zealand. VEDA also publishes a newsletter for members called On the Level. On their website they offer information for physicians that want to learn more about vestibular disorders and you will also find a list of physicians who specialize in treating vestibular disorders to help people who may be having difficulty finding a doctor that understands their condition. VEDA can be contacted at (800) 837-8428 (voice mail) or e-mail them from their website.

    References

    • The Ear InfoSite (Link is no longer available) is a website of information about dizziness and hearing loss sponsored by the Portland Otologic Clinic. The site includes a description of how the balance system works and information about the most “Common Syndromes”. These are Meniere’s Disease, Benign Paroxysmal Positional Vertigo (BPPV), Post-traumatic Vertigo, and Vestibular Neuronitis (labyrinthitis). There is also a glossary of terms associated with dizziness and balance disorders.

    • MedicineNet.com (Link is no longer available)

    • The Meniere's Page (Washington University) (Link is no longer available)

    • The Vestibular Disorders Association (VEDA) is an international organization based in Portland, Oregon that offers a great deal of information, resources, advocacy and support for people suffering from inner ear disorders that cause dizziness, nausea, and balance problems. This includes information on causes, diagnostic tests, treatments, symptoms, research and the body's balance system.

    -