Dizziness & Loss of Balance

Overview

Hearing and balance work together in that your sense of balance lies within your inner ear. Fluid filled channels in your inner ear respond to movements and signal movement to part of the brain.

Dizziness & Loss of Balance Causes

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

• 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 spins 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 condition mainly causes 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 usually occurs in both ears.
• Benign paroxysmal positional vertigo. This condition most often causes ear-related dizziness. This vertigo may have no identifiable cause or relate to a sudden jolt to your head. It could also relate 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.

How We Can Help

IU Health Ear, Nose & Throat physicians have unmatched expertise with these conditions. Physicians 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.

Through their association with Indiana University School of Medicine, your physicians educate the next generation of doctors about dizziness and loss of balance conditions. They participate in research focused on the science behind inner ear and balance disorders so they can develop more effective treatments for you.

Treatment

IU Health physicians offer the following treatments and services for conditions that cause dizziness and loss of balance.

Ménière’s Disease

Your physicians’ treatment of this disorder focuses on reducing the pressure in your 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 control symptoms. When dietary and medical therapies do not control Ménière’s disease, a procedural intervention may help.

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

Your physicians 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 spins around you) to the brain. Destroying these hair cells also causes hearing loss in the affected ear, but relief from continual vertigo can sometimes provide the better choice.

Vestibular Neuritis and Labyrinthitis

Many physicians have difficulty diagnosing these disorders because symptoms have similarities with other conditions. Your IU Health specialists have experience making this distinction and providing appropriate, effective treatment.

Your physicians treat infections promptly with the right medicines because infection may cause you permanent hearing loss over time. Viral infection can cause vestibular neuritis and labyrinthitis, but sometimes bacterial infection causes it.

Your physicians may treat you with antibiotics for bacterial infections. Viral infections may respond to antiviral drugs, or your physicians may use other medicines to control your symptoms. Balance rehabilitation may help you achieve long-term control of vertigo.

Superior Semicircular Canal Dehiscence

To manage SSCD, your physicians will recommend that 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. Your surgeons may use small bone chips taken from your skull to make the repair. This often gives you long-term control of symptoms with minimal side effects.