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Dizziness & Loss of Balance

Dizziness and loss of balance are disorienting, but are often treated successfully. Hearing and balance are intimately connected because our sense of balance is located in the inner ear. In this part of the ear, there are fluid filled channels that respond to movements and signal that there is movement to part of the brain. Part of this process involves a liquid within the inner ear that moves tiny hair-like cells. These hair cells stimulate the nerve that carries balance information to the brain.

Four common disorders that cause dizziness or loss of balance are:

  • Ménière’s disease. Symptoms of Ménière’s disease include hearing loss, tinnitus (ringing or roaring in the ear) and positional vertigo (a spinning sensation or a feeling that the world is moving around you). Hearing loss usually affects only one ear. Vertigo associated with Ménière’s disease may cause problems in daily living.
  • Vestibular neuritis and labyrinthitis. Both of these conditions may cause mild to severe vertigo. Labyrinthitis may also affect hearing. Disorienting loss of balance may come on suddenly.  
  • Superior semicircular canal dehiscence. The semicircular canal in the ear is one of three tubular loops that contain fluid essential for balance. The main symptom of this condition is dizziness brought on by loud sounds or by actions that cause pressure in the inner ear, such as sneezing or coughing. Superior semicircular canal dehiscence is usually present in both ears.
  • Benign paroxysmal positional vertigo. This condition is the most common cause of ear-related dizziness. This vertigo may have no identifiable cause or be related to a sudden jolt to your head. It could also be related to migraines or disorders that damage your inner ear. You may experience dizziness, a sense that the room is spinning or lightheadedness. Episodes can occur quickly, though months may pass between episodes.

You may be able to recover from dizziness and loss of balance and return to normal activities. At Indiana University Health, you receive comprehensive, patient- and family-centered care. We are dedicated to accurate diagnosis, effective treatment and excellent follow-up care for your inner ear disorder. Our expertise with these conditions is unmatched. We have physicians who are board certified in neurotology, a highly specialized discipline devoted to disorders of the inner ear and nerves related to it. Care at IU Health includes physical therapy and rehabilitation to help you recover and return to normal activities.

The IU Health Balance Clinic helps patients with balance disorders that have caused them to fall. Falls may result in serious injuries and visits to the IU Health Emergency Department. The Balance Clinic provides personalized care to help patients manage their balance disorders and avoid dangerous falls.

Through our association with Indiana University School of Medicine, we are educating the next generation of doctors about dizziness and loss of balance conditions. We participate in research focused on the science behind inner ear and balance disorders so we can develop more effective treatments.

How We Can Help

How We Can Help

Dizziness & Loss of Balance Treatment Information

We offer the following treatments and services for conditions that cause dizziness and loss of balance.

Ménière’s Disease

Ménièier’s disease causes spells of vertigo and loss of balance that may last minutes or hours. You may also have nausea, difficulty walking and be unable to drive. The cause of Ménière’s disease is pressure in the fluid of the inner ear.

Our treatment of this disorder focuses on reducing the pressure in the inner ear. For most people, eating a low-salt diet relieves this pressure, which eliminates symptoms or reduces them to a manageable level. Diuretic medications may be used to control symptoms. When dietary and medical therapies do not control Ménière’s disease, a procedural intervention may be needed.

This may include a surgical procedure, such as an endolymphatic shunt (an internal drain tube), which may relieve pressure in order to control vertigo.

We may also inject an antibiotic called gentamicin directly into the liquid in the inner ear. Gentamicin destroys the hair cells that transmit the signals of vertigo (a sense of spinning, or a feeling that the world is moving around you) to the brain. Destroying these hair cells also causes hearing loss in the affected ear, but relief from continual vertigo is sometimes the better choice.

Vestibular Neuritis and Labyrinthitis

Infections in the two vestibular branches of the vestibular-cochlear nerve cause vestibular neuritis and labyrinthitis. Neuritis only affects the nerve branches that carry balance impulses to the brain and causes no hearing loss. Labyrinthitis is an infection of both branches of the vestibular-cochlear nerve, and it causes both vertigo and hearing loss. These disorders may be difficult to diagnose because symptoms are similar to those of other conditions. Our specialists have experience making this distinction and providing appropriate, effective treatment.

We treat infections promptly with the right medicines because infection may cause you permanent hearing loss over time. Viral infection is a common cause of vestibular neuritis and labyrinthitis, but sometimes the cause is a bacterial.

We may treat you with antibiotics for bacterial infections, but viral infections may be more difficult. Sometimes they respond to antiviral drugs, or we may use other medicines to control your symptoms. Rehabilitation may help you achieve long-term control of vertigo.

Superior Semicircular Canal Dehiscence

Three small loops containing fluid in the inner ear provide your sense of balance. These loops are called semicircular canals. An opening (dehiscence) in a tiny bone connected to one of these loops causes superior semicircular canal dehiscence (SSCD). With this disorder, loud sounds may cause you to have vertigo.

To manage SSCD, we recommend you avoid loud noises or activities that cause sudden pressure in the semicircular canals. If you have severe symptoms, you may need surgical treatment. Surgery for SSCD involves repair of the damaged bone to close the hole and lessen vertigo and hearing problems. We may use small bone chips taken from the skull to make the repair. This often gives you long-term control of symptoms with minimal side effects.

Dizziness & Loss of Balance Locations & Physicians

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Dizziness & Loss of Balance Support Services

Knowing more about these conditions can help you work with your doctor to overcome or manage them. IU Health also offers support and rehabilitation for balance disorders. The sites below provide additional information about dizziness and loss of balance conditions.