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.