Balance Problems


March 24, 2013: 8:07 am: Balance Problems

by Neil Bauman, Ph.D.

More than 7 million people in the USA suffer from vertigo, a condition where they feel the room is spinning around them. One of the most common forms of vertigo goes by the tongue-twisting name of Benign Paroxysmal Positional Vertigo (BPPV). It is also one of the easiest forms of vertigo to treat.

In the past you would go to an ear specialist (ENT doctor) and he would typically perform the Epley maneuver on you to reposition the otoconia (tiny rocks in your head made of calcium carbonate crystals). These tiny crystalline rocks help you keep your balance by sensing gravity. They normally reside in the utricle in the vestibular (balance) part of your inner ear. However, sometimes these “rocks” get jarred out of their normal location and “fall” into one of the three semi-circular canals. (The semi-circular canals sense turning motions in each of three different planes.)

When the “rocks” touch the tiny cilia in the semi-circular canals, they generate false balance signals. As Dr. Carol Foster explains, “The semicircular canals are only capable of sensing turning motions, so the presence of particles moved by gravity causes tilting motions of the head to be incorrectly sensed as violent spinning” (1) or vertigo.

Often the vertigo first strikes you when you are in bed and not when you are standing. This is because when you are upright the entrance to the semicircular canals lies just above the gravity sensors (utricle)—and “rocks” don’t fall upward! However, when you are lying flat on your back, the entrance to the semi-circular canals is located just below the utricle. This means that gravity coupled with side-to-side rolling movements as you roll over in bed can accidentally “knock” the otoconia into the opening of the semi-circular canals.(1)

As Dr. Foster explains, “Rolling over in bed to one side can cause a very sudden, strong sensation of head-over-heels whirling that lasts for several seconds and then dies away. If the eyes are open the room can appear to spin violently. Attempting to sit up from lying down, to lie down from sitting, or to roll over while lying down can cause the symptoms to recur. After getting out of bed, symptoms can be brought on by tipping the head upward (while shampooing or reaching up toward a high shelf, for example), looking back over one shoulder, or by bending over forward and then lifting the head quickly.” (1)

The good news is that recently Dr. Foster discovered a do-it-yourself method to reposition these “rocks” and thus alleviate the vertigo. She calls it the Half Somersault maneuver.

If you have BPPV and want to try it for yourself, here is the link to the instructions for the Half Somersault maneuver. Just be prepared for some vertigo in the process, but it should go away as you progress through these maneuvers.
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(1) Carol Foster. Benign Paroxysmal Positional Vertigo (BPPV). Marion Downs Hearing Center. Boulder, CO. http://www.mariondowns.com/bppv.

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November 14, 2012: 8:25 am: Balance Problems

by Neil Bauman, Ph.D.

A man explained,

My younger brother is in his 30s. He developed bilateral vestibular problems of unknown cause. Now he doesn’t have any vestibular (balance) function left in either ear. He does OK during the day while walking on a hard surface as long as he has a cane or walking stick, but he still struggles with hills, slopes and stairs as well as when walking on soft surfaces. His eyes bounce when he walks and he often complains of this.

He has a tremendous amount of difficulty in busy places with lots of commotion and often times will use a power chair in such places as he struggles to keep from falling. The rest of the time he is able to manage with his walking stick or cane. He complains a lot about fatigue and I am hoping that will improve as well.

He is a teacher and we all hope he will be able to return to work one day but the stimuli of a busy classroom is very difficult for him.

My question is, “Do people with his condition ever regain their ability to drive?” What has been your experience with driving and loss of all vestibular function? I am hoping he will be able to drive again one day with rehabilitation.

Your brother’s condition goes by the fancy name of oscillopsia (pronounced ah-sih-LOP-see-ah) or bouncing vision. Oscillopsia occurs when your vestibular system is totally destroyed in both ears. Living with oscillopsia is not easy as you now know.

Fatigue is a constant companion. This is because the thinking part of his brain now has to take over the vestibular function as much as it can—a job it is not designed to do—in order to help keep him from falling. All this extra work takes a lot of energy.

It also means that his mental status will be “foggy” because his brain is so busy with balance issues that there is not enough “horsepower” available to optimally process things to be stored in memory, to think with and to process visual information.

That is why he has so much problem staying balanced in “busy” places. There is just too much sensory input for his overworked brain to process. “Busyness” isn’t only a lot of motion, it can also just be “busy” visual patterns. For example, the visually “busy” aisles in grocery stores can be too much to process so he may have to look at the simple patterns on the floor in order to be able to keep his balance.

Trying to find a place that isn’t visually “busy” is hard amidst the bustle of a city. But he can have problems, even amidst the wide open places in the country. For example, the wind blowing long grass or crops, or waves lapping the shore, can also be disorienting.

As he adapts to his lack of balance, he will find some tricks that will help him and thus take some of the load off his brain. Hopefully he’ll not be as fatigued, but keeping his balance will never be easy.

Personally, I don’t think it is a good idea for him to drive. He might be able to drive in a small town—but when something goes bad—a child darting across the street or a car whipping around the corner—the visual busyness may be too much for his brain to process fast enough and still do the right thing. So until he learns to cope in visually busy situations while walking—I wouldn’t recommend even attempting to drive.

I can only think of one man with oscillopsia that drives. He has to be very careful where he drives and he never drives at night, in poor light, in busy situations, etc. Typically, people with oscillopsia do not drive. In addition to the confusion caused by the “busyness” of congested roads, their bouncing vision can make it impossible for them to read traffic signs, etc. so they are not really safe to themselves or to others.

As for his career, if he is a good teacher, there is no reason for him to give up teaching as such. However, the visual “busyness” of the classroom may be too much for him. Even so, all is not lost. There are other possibilities. For example, he could tutor students in a small visually-plain room. He could also design/prepare lessons rather than actually teach them. In addition, he could teach people via a computer or phone. As you can see, there are lots of possibilities—but he’ll have to think outside the box.

Unfortunately, there is no easy way to overcome this balance problem. One secret to balance success is for him to constantly challenge his brain with exercises to help it strengthen its balance-processing capabilities.

My article “Protect Your Balance System, or Else…” will give you a lot of additional information on balance.

You may also be inspired by one man’s story of how he largely overcame his balance problems. You can read “Regaining Balance—One Man’s Story” here.

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October 25, 2012: 7:07 am: Balance Problems

by Neil Bauman, Ph.D.

On September 14, 2012, two people in Holland were implanted with a new kind of vestibular (balance) implant—one that generates orientation and acceleration signals to replace the balance signals that dead or non-functioning hair cells in the semicircular canals of the inner ear used to produce.

Although it is too soon to know how well such implants will work, so far, preliminary results look positive.

Researchers are hoping that the brain will learn to integrate the signals from the balance implants with the existing balance signals it receives from the eyes and proprioceptive systems.

If the implants ultimately prove to be successful, they will give balance (to some degree or other) back to people whose vestibular (balance) systems were destroyed by drugs or diseases such as Meniere’s Disease.

Vestibular implants are still in their infancy—where cochlear implants were back about 30 years ago. Over the past 30 years, there have been tremendous strides in how well cochlear implants work. I have no reason to believe that vestibular implants won’t do the same in the future.

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July 6, 2012: 11:51 am: Balance Problems

by Neil Bauman, Ph.D.

A man wrote,

I am very interested in hearing and balance and was looking for your thoughts—I know you are not an MD, but would appreciate your views.

If someone is having vertigo from a serious disease such as bilateral Meniere’s disease, is such a person better off without a vestibular system in the long run as his eyes and proprioceptive system will eventually take over for the loss of his ears?

Also, I know falls are a leading cause of death due to bad balance. As a result, are people who have vestibular loss/damage better off using wheelchairs outside where fast moving objects and other stimuli could cause them to fall over and seriously injure themselves?

Does someone without any vestibular function in either ear require a wheelchair for safety, independence and to compensate for poor balance?

I congratulate you on your wanting to know more about ears and balance and how people with poor balance can effectively cope with their balance problems.

As you know, your body contains not just one, but three separate balance systems—the vestibular system in your inner ears, your eyes, and the proprioceptive system in your lower legs and feet. You need two of these three systems working in order to maintain your balance.

There is no cut and dried answer to whether a person with Meniere’s disease is better off without a faulty vestibular system or not. Much of it boils down to personal choice. Some people choose to kill off all their remaining vestibular function in an attempt to end intractable vertigo. Other people choose not to. I think much depends on just how bad their vertigo is.

However, of all the people I know with bad balance (and I know a good number), I can’t think of any that use a wheelchair solely for reasons of bad balance.

Perhaps this is because typically Meniere’s disease occurs in mid-life while a person still has a reasonably active lifestyle, rather than in elderly, frail people.

Furthermore, sitting in a wheelchair is actually counterproductive. You see, the truth is, the more you exercise your remaining balance organs, the better your brain can maintain your balance. Let me give you some examples.

I’m thinking of three men—one plays golf every day to keep his balance working. The second one goes hiking all over the world—but he typically takes two walking sticks with him on rough or dangerous trails. I’ve been out hiking with the third man. He lurches and staggers around like the proverbial “drunken sailor”, but doesn’t fall down. He typically uses a hiking stick. He also has a big service dog which is trained as both a hearing ear and a balance dog.

So does a person without any vestibular function require a wheelchair? Generally I’d say “no”. Walking sticks—yes, but wheelchairs—no. Of course there are exceptions depending on the person’s age, frailty, health, etc.

Typically, people need to maintain an active lifestyle for optimal health and balance. Thus, those still vigorous enough need to walk and to do other exercise in order to keep their balance systems working as well as possible.

However, at night, it is prudent to have another person with you to lean on as necessary as your eyes don’t help much with balance in dim light and do nothing to help you in the dark.

If you have no useable vestibular function, you should follow these guidelines.

1. Walk on firm surfaces when you are “working”. When you walk on uneven or soft surfaces you negate your proprioceptive system. Save walking on soft or uneven surfaces for times when you are actively working on strengthening your balance systems and it is safe to do so.

2. Move around in the light. In the dark you lose the balance assistance your eyes provide.

3. Especially avoid walking on soft or uneven surfaces at night as you basically have no functioning balance systems left to help you.

4. Avoid visually “busy” scenes. For some people walking down aisles in the supermarket is too much. They need to focus on the floor to maintain their balance. And if the floor has a busy pattern, even that won’t work.

5. When riding in a vehicle, sit on the driver’s side in the back seat, or half way back on a bus. That way you can’t see the visually busy road out the windshield and can’t see the fence posts, poles, etc. whizzing by on the side of the road that can make you dizzy and upset your balance.

As you can see, there are a number of effective coping strategies people can employ to help themselves get around even though their vestibular systems are shot. How much better to employ these strategies and remain independent rather than give up and live in wheelchairs.

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January 16, 2010: 10:40 am: Balance Problems

by Neil Bauman, Ph.D.

If all of a sudden you feel dizzy and your balance is off, has something just happened to the balance parts of your inner ears, or have you just had an ischemic stroke in your brain? Your doctor needs to determine what has happened right away.

Up to now, doctors typically ordered MRIs to look for a blood clot in your brain which would indicate a stroke. Unfortunately MRIs are both expensive and do not always find tiny blood clots, especially at the outset.

Now researchers at Johns Hopkins and the University of Illinois have discovered a fast, accurate, low-tech way to determine which is which. Your doctor can tell in under a minute whether you’ve just had a stroke or not. Here’s how he can do it.

Your doctor gives you a three-part eye test called H.I.N.T.S. (In case you’re interested, H. I. stands for “head impulse”, N.T. for “nystagmus test” and S. for “skew”.)

First, is the Head Impulse Test. Here your doctor rotates your head while you keep your eyes focused on his nose. If you have had a stroke you cannot do this. However, if you have an inner ear balance problem, you can keep focused on his nose.

Second, is the Nystagmus Test. You follow your doctor’s finger as he moves it. If you have a balance problem, your eyes will jerk in only one direction. However, if you have had a stroke, your eyes will most likely jerk in both directions.

Third, is the Skew Test. Here your doctor looks at your eyes to see if one eye appears higher than the other. If one eye is higher than the other, you have had a stroke. If they are the same level, then it could be inner ear balance problems.

According to David E. Newman-Toker, MD, PhD, assistant professor of neurology at Johns Hopkins University School of Medicine and coauthor of this study. “These three eye tests tell, with 96% certainty, whether or not the patient has had a stroke.”

According to Bottom Line’s Daily Health News, December 14, 2009, “Dr. Newman-Toker advises seeking attention for any dizziness that comes on unexpectedly and has no obvious explanation, particularly if it lasts more than a few seconds. In situations where you still feel dizzy when you arrive at the ER, request the eye tests, he says, but be aware that not every doctor has the training and experience to perform them.”

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December 22, 2008: 1:28 pm: Balance Problems

by Neil Bauman, Ph.D., with Tony

In 2005, Tony had surgery to remove a large (4.5 cm) acoustic neuroma (non-malignant tumor) growing on his left auditory nerve. In the course of removing the acoustic neuroma, the surgeon, not only had to cut the auditory nerve leaving him totally deaf in his left ear, but also severed the vestibular nerve, thus totally destroying the balance system on his left side. The result of this surgery left Tony wheelchair-bound. However, he didn’t stay there. With vestibular therapy and much hard work, Tony now can lug his golf bag around the course as he plays 36 holes of golf. Here is his story.

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Three years ago I lost a balance nerve to surgery and was left in a wheelchair. I could not walk unassisted, and had to relearn how to balance myself again. This was a long process. However, given the benefits and independence I now have, it certainly was worth it!

After the surgery, my first experience with poor balance occurred when I fell out of my hospital bed—face down onto the floor with some force. Ouch! You see, the surgery had cost me my left side balance, and I didn’t realize just how “shot” my balance system was.

As the days went by, I became increasingly aware that my lack of balance was affecting me in many other ways. For example, I fell numerous times. (In self-defense, I kept an eye out for somewhere soft to land if possible. I needed an area where a fall was not going to hurt me.) I collided with people and objects. I was clumsy. I often dropped things. I found it was a good idea to stay away from work on ladders!

Furthermore, I had trouble coordinating my left and right hands. This was brought home to me 8 weeks later when I was trimming the hedge and nearly lost a finger to the electric cutters!

Each day as the hours went by, I became more and more tired. The result was that my coordination became progressively worse to the point where I was not able to move around safely.

Consciously keeping my balance proved to be exhausting. I experienced profound fatigue when engaged in almost any task, whether physical or mental. My lack of balance affected my speech too. The wrong words came out, or I mispronounced words.

My short-term memory dropped dramatically. You see, the effort involved in consciously maintaining balance like I now had to do affected my short-term memory. As a result, in addition to my speech problems, I easily forgot simple things, and was forever losing things.

For several months after my surgery, I needed a midday nap. Unfortunately, napping messed up my night-time sleep patterns, and I would be awake in the early morning hours. The result was that I invariably awoke exhausted before the day had even started! All these balance-related problems reduced my self-confidence. I became both frustrated and depressed.

While I was still in the hospital rehabilitation unit, I was determined to get well. I requested assistance in using the gymnasium, but was told no one was available to help me. Next day, while still in my wheelchair, I broke into the gym and began using the equipment by myself. They were not too impressed with my actions (I was spotted on the security cameras), but I made my point. The following day suddenly staff were available to assist me. I made rapid progress. My stay was just 32 days, not the expected average of 82 days.

To get my balance back I needed to exercise. To some degree it almost doesn’t matter what the exercise will be. The real key is to do something that you really enjoy and be able to stick at over a long period of time. For me that was playing golf!

Hospital rehabilitation got me walking again, but my first golf experience showed me just how weak and frail I had become. For example, when playing my first golf game (four months post operation), I could only manage four holes before becoming completely exhausted.

Therefore, I set out on a course to rebuild both my balance and my stamina. Fortunately I was (and still am) a keen golfer, so I did not consider time devoted to playing golf as a big issue.

Golf involves a combination of balance, movement, and eye/hand coordination. In this respect, golfing was an ideal therapy for me. Throughout all the days, whether sunny or rainy, I don’t ever recall thinking “this is a chore”. Rather, my feelings were, “I am getting better” (both my balance and my golf game)!

Throughout all this rehabilitation I felt so tired—close to complete collapse was more like it. However, I discovered that if I simply stopped, sat down somewhere quiet, and shut my eyes for 10 or 15 minutes, something quite miraculous happened. These short breaks were equivalent to about four hours sleep in terms of my body’s recovery. They had the added advantage that they did not disrupt my night-time sleep patterns.

I really pushed myself. However, there is a fine line between pushing yourself and overdoing it. When I really did overdo things, my coordination became increasingly erratic. At this point, drills, power tools and hammers were simply too dangerous for me to use—best kept safe for another day.

Over time, my strength and stamina slowly returned. I was now able to take on increasingly longer and more demanding exercises. My average golf practice now consisted of 140-160 long-range shots, considerably more than in a full game of golf.

As my balance improved, I also noticed that my thinking and coordination improved as well. I could now get through a day without a nap.

Just how much I have improved really came home to me when I moved 300 sidewalk slabs (over three and a half tons) from the front of my house to the back garden. It took me four hours. Yes, I was smashed afterwards, and hurt just about everywhere, but I did it!

My balance will never be perfect. My new balance system requires a visual point of reference. In other words, if it is completely dark, even simple movements are difficult. Thus, in the dark I find it wise to carry a flashlight. At home, I use low-wattage nightlights in the hall. This makes a big difference when I am moving around in the early hours.

When walking up and down stairs I usually extend both elbows out as additional stabilizers. I’d rather have a bruised elbow than a bruised head! Uneven ground almost always presents a challenge for me. I’ve found it best not to try and carry stuff in such circumstances.

I am not anti-alcohol, but my new balance system does not cope as well with the effects of alcohol as my old one did. My tolerance to alcohol is now reduced. These days I only drink at home when there is no possibility of any further travel or driving that day.

Because my brain is more occupied with keeping me balanced than in remembering things, I’ve found that it is worthwhile for me to take notes during meetings and to create to-do lists rather than relying on my now faulty memory.

Without a doubt, regaining my independence definitely helped my feelings of self-esteem and self-confidence. I can now work a 12 hour day with a two-hour journey at each end. Equally, I now understand and value rest when I can take it. All of this was possible only because I took the rebuilding of my balance and my health to be a fundamental and key issue in my life. Now, I am no longer confined to a wheelchair, or to walking with a cane. Finally, and to the disgust of my golfing friends, I can now beat them at their own game! This I call “success!

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To learn more about your balance system, how all the various parts work together and what happens when it gets damaged, read “Protect Your Balance System—or Else“. If your balance system has been damaged, take courage and follow Tony’s example. Never give up. Rebuild your balance system as much as is humanly possible. When you do that, you too will find your level of success!

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May 23, 2008: 4:56 pm: Balance Problems

by Neil Bauman, Ph.D.

A woman explained:

I read one of your articles on the Internet about SSHL (Sudden Sensorineural Hearing Loss), which I had when I was 11 years old. I had 80% loss in my left ear, which has been permanent. I am now 54 years old. The diagnosis of the cause of the hearing loss was an unknown virus. At the time of the hearing loss I did experience vertigo.

My question is, over the years I have experienced periods of vertigo. Usually one episode every 2 – 3 years. In the past 5 years I have had 4 or 5 episodes. I do not experience hearing loss or tinnitus. The vertigo becomes severe, and I usually have to lie down with my eyes closed for 24 hours on average. Plus in the last few episodes I have had extreme nausea (vomiting every few hours for 24 hours). I have been through extensive tests with an ENT doctor, also had an MRI, and his only opinion is that the vertigo is related to some extra sensitivity related to my nerve deafness. My question is, do people with SSHL often experience vertigo later and throughout their lives as I have described?

I’m not surprised you had some vestibular (balance) problems in addition to your sudden hearing loss. The virus that gets into your cochlea and causes hearing loss, often at the same time, gets into the vestibular system and causes balance problems such as your vertigo. However, that happened many years ago now. I wouldn’t have expected vertigo from back then to still occur. Perhaps these episodes of vertigo are not directly related to the original viral attack.

One possibility is that you may have a form of Meniere’s disease that only affects the vestibular system and not the whole inner ear. It may be called endolymphatic hydrops, but more commonly it is known as vestibular hydrops. This could account for your periodic attacks of vertigo without the accompanying tinnitus and hearing loss. Have your doctors considered this?

Do you have any allergies at all? If so, do the episodes of vertigo correlate to the allergy outbreaks? Often allergies are the underlying cause of Meniere’s disease.

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February 19, 2008: 10:21 am: Balance Problems, Recruitment & Hyperacusis

by Neil Bauman, Ph.D.

A veteran wrote:

My hearing loss and tinnitus is service-connected. I was exposed to constant cannon fire while in the Marine corp. No hearing protection. Marines were expected to tough it out. Now I’m paying for that silly theory with my hearing problems.

I am trying to explain to the VA doctors and audiologists about my severe sensitivity to sound. Some loud sounds hurt my ears really bad. This is causing me to have anxiety and panic attacks secondary to the loud sounds.

The VA has said that my problems are psychological so I’m now seeing a psychologist. I am very depressed because of my inability to hear well, and my tinnitus is extremely loud. I sometimes think that there are mice in my ears scratching to get out. The tinnitus and combined hearing loss is very depressing, but so also is the sensitivity to loud sounds.

Loud sounds cause me to become disoriented and dizzy and I lose my balance. Several times, upon hearing loud sounds, I have fallen. I realize that this is caused by my anxiety reactions and panic reactions to the pain of the loud sounds. My problem is that I can’t seem to make the VA medical people understand.

They just think I have to get over the depression. They think the depression is causing the problem and that when the depression goes away so will the tinnitus and sensitivity to sound. I also hear phantom sounds, which I know are a part of my hearing loss and tinnitus. But again the VA is saying no. They want to blame it on psychosis? The bottom line is that the depression, anxiety and panic disorder are secondary to my hearing problems.

Fear of sounds is called phonophobia. In your case you perceive the sounds as so loud they hurt. No one wants to be hurt—whether it is loud sounds or anything else.

However, I think that rather than having phonophobia, you have hyperacusis—where you perceive normal sounds as too loud. Hyperacusis is often the result of having your ears damaged by loud noise such as you were exposed to in the Marines.

Living with loud tinnitus day in and day out can lead to depression. Actually, this is sort of a Catch 22 situation. Depression often leads to louder tinnitus—so you want to get your depression under control in order to help control your tinnitus, but on the other hand, loud tinnitus leads to depression, so you want to get your tinnitus under control if at all possible.

You can learn to live and enjoy life even though you have tinnitus and can’t hear much. I don’t hear much at all now, and I’ve had tinnitus day and night for 35 or more years—but I don’t let it affect my happiness. My book, “When Your Ears Ring—Cope With Your Tinnitus—Here’s How” has helped many.

It’s interesting (not nice, but interesting) to note that loud sounds also cause you to lose your balance. I don’t see how it relates to anxiety reactions like your doctors think it does. To me, it seems you have a condition called Tullio’s Phenomenon in which people lose their balance from loud sounds—not from anxiety or panic.

Another name for it is Superior Canal Dehiscence Syndrome. Basically what happens is that you have a hole or thin spot in the bone separating the balance system from the hearing system. Thus when you hear a loud sound, the sound wave travels via the hole to act on the balance system. Since it is a sound signal and not a balance signal it sends false balance information to your brain. This totally confuses your brain and the result is loss of balance. Some people drop to the floor like they were knocked out. Others have vertigo and some dizziness and imbalance. Sometimes doctors can patch the hole and cure this, but other times not.

If this is what you have, then the psychologist is wrong in trying to treat you for anxiety and panic. Yes, you need to get those under control too, but you also need to have an otologist check you out for things that cause Tullio’s Phenomenon such as Superior Canal Dehiscence Syndrome.

You have several ear related problems and each one needs the proper treatment by the appropriate professional. Blaming it all on you just isn’t going to help!

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April 28, 2007: 8:35 am: Balance Problems

by Neil Bauman, Ph.D.

A man wrote:

I hope you can help me It all started on March 11. I got to work and started walking to the job and got dizzy and light headed. During the next 3 hours, I felt worse and worse. I got sick to my stomach. I called my wife to come and take me to the hospital. As we were going to hospital my chest, hands and feet felt numb. At the hospital I told them my chest hurts, my hands and feet feel numb, and I’m spinning. I was in the hospital 10 days.

After I got out, they sent me to an ENT doctor because I had lost the hearing in one ear. He put me on Prednisone and some other drugs. My hearing came back quite fast. However, since this happened, I need to use a walker because I am dizzy. My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy.

I am just 54. They have done an MRI and found nothing. They say only my left ear was involved. The neurologist said today that a small blood vessel going to my ear could have caused a small stroke. Of all of the stories that I’ve read on the Internet, no one talks about numbness. Furthermore, I can’t believe that hearing plays that much of a role in having to use a walker.

That’s quite an experience you have gone through. I agree with you that numbness is not a part of “ear problems.” Typically, numbness is the result of a lack of blood flow to the affected parts of your body. Hence the sensor nerves there (pain, heat/cold, pressure, etc) temporarily cannot send their messages to your brain. Thus you have the numb feeling (or rather lack of feeling).

Whatever you had obviously affected your whole body, including one of your ears. When the blood flow was cut off to this ear, it immediately affected the two things your ears give you—your hearing and your balance.

Since the vestibular parts of your inner ears are the main balance organs in your body, when one or both of them are damaged, you typically get violently sick and the room spins— just as you experienced.

Thankfully, your hearing came back, but you are now left with what appears to be some permanent balance problems. Let me explain what happens in your ears that causes you to have these balance problems.

Your inner ears consist of two parts, the cochlea and the vestibular system. When something damages the cochlea, you lose hearing. Apparently the same thing that affected your cochlea also affected your vestibular system causing your dizziness and vertigo. Often both are damaged together since both structures lie side by side and share the same fluids.

Perhaps you don’t know this, but you actually have 3 separate balance systems in your body. First, and the most important, is the vestibular system in your ears. Second is your eyes. Trailing a distant third is your proprioceptive system (pressure sensors in your legs and feet).

Since there are two of each of these subsystems, you really have 6 separate parts of your balance system—all sending balance information to your brain. If all 6 send the same consistent information, you have normal balance.

However, if one (or more) of these parts is damaged and begins to send different (false) balance information, then instantly your brain is confused. The result is the dizziness and vertigo (spinning) you experienced.

Fortunately, over time, your brain generally learns how to ignore the bad signals. When this happens, the vertigo and much of the dizziness goes away. It can take a few months or more for your brain to adjust.

One thing that helps is to do balance exercises that teach your brain to ignore the bad balance signals, and only use the good ones.

One more point. You mention, “My wife drives me around, and just the motion of the car, and seeing cars whiz by makes me dizzy.” This is often the result of damage to your vestibulo-ocular reflex. This is just a fancy way of saying that the vestibular system in your inner ears and your eyes are tied together in intricate and wonderful ways so that when you are moving around your eyes have a stable horizon or reference point.

When this vestibulo-ocular reflex is damaged or broken, then your eyes move independently, rather than being coordinated by your brain to move in unison with your body movements. One of the results is the dizziness you feel when you, or something around you, is moving.

When you wrote, “I can’t believe that hearing plays that much of a role in having to use a walker,” you were only thinking of your ears as hearing organs. By now you realize they are so much more—they are critical to proper balance. When you don’t have good balance as you have unfortunately discovered, you cannot always function independently.

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December 21, 2006: 10:09 am: Balance Problems, Hearing Loss

by Neil Bauman, Ph.D.

A concerned mother explained:

Our daughter is 8, and has a bilateral vestibular disorder. She has trouble reading and if she reads too much she will get horrible vertigo spells. Even her gait is affected. When she comes home from school on Friday, her stance is wider than normal and she tends to plop her feet down. This abnormal gait disappears by Saturday.

Other than balance and hearing difficulties that come and go, she appears fairly normal. I liken my daughter’s brain to ‘RAM’ on a computer. It seems her brain does not have enough ‘RAM’ to hold several ‘programs’ open at once, unlike a computer (and most people’s brains) which can hold open, and use, several ‘programs’ at a time.

For example, if she’s using her vision program, her hearing and motor programs may shut down. If she’s using her hearing, her vision and motor programs may shut down. If both her vision and hearing programs are taxed beyond their limits, her vestibular program can’t operate either.

If she’s in a busy place such as a grocery store, or even at school, her vision goes first, then her hearing, then her muscle control and finally her balance. She literally slithers out of her chair to lie prone on the floor for which she gets into great trouble at school for ‘refusing to listen’ and get back up in her chair, going to her room to get some quiet, etc.

Her inability to keep more than one program open at a time also leads to very high distractibility. For example, if she’s looking, she can’t hear. If she’s listening, she’s not looking. If she’s walking and hears a noise, she drops whatever is in her hand.

Do you know of anyone that has a child who even remotely behaves like this?

Your daughter’s behavior seems so strange so as to be almost unbelievable–but similar things happen to other people too.

Although your daughter has several health problems, if she had just lost her balance system, she could have similar experiences.

You see, normally our balance (vestibular) systems work automatically and subconsciously behind the scenes. However, is something destroys our vestibular system, then the conscious parts of our brain have to take over for the subconscious parts (in this case, the vestibular parts) and try to keep us upright. This requires a lot of RAM (to use your analogy) and when too much is used for balance, then the other systems suffer (and may fail). Symptoms of a  damaged/destroyed vestibular system may include memory loss, fatigue, nausea, blurred vision and other visual problems, and in extreme cases, sensory shut-down.

A lady recently told me about her sister, an RN, who had something similar happen to her. This sister had taken Gentamicin drops in her ear on her doctor’s orders–but she had a hole in her eardrum and the Gentamicin got into her middle ear, and from there totally destroyed the balance in her inner ears.

She wrote:

My sister has been diagnosed with vestibular damage [balance problems], nystagmus [eyes jerking horizontally], and oscillopsia [bouncing vision]; she experiences all the gamut of symptoms you mention–the vertigo, dizziness, nausea, vomiting, and ataxia [staggering gait]. She even experiences motor function shut-down, and a loss of consciousness when in an environment that becomes too challenging for her brain–too much visual stimuli.

Particularly notice that last sentence. This is somewhat similar to what your daughter is going through. Notice that this nurse experiences too much sensory overload, she too, “slithers to the floor” so to speak–totally out of it.

Thus, if a person has vestibular system problems such as both your daughter and this lady have, the answer is twofold. First, try to cut down on the amount of sensory stimulation that you receive at any given time. This may mean simplifying your environment so as not to overload your brain and cause it to shut some systems down in order to cope. Second, schedule a number of “quiet time” breaks in a less challenging atmosphere throughout the day in order to give your brain time to recover before it shuts some things down.

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