Balance, Dizziness And Motion Sickness
What is the relationship between my ears and my sense of balance?
The ears help with your balance because they are made up of a hearing system and a balance system. The balance system in the ear sends signals to the brain to let you know where you are in your environment. The signals are also transmitted to the eye and to your extremities, and transmitted back to the ear and into the brain so all systems work together. If you have a problem with the ear, and the balance system, you have dizziness or vertigo. A mild form of vertigo would be motion sickness. A more severe form of vertigo would be where there's a severe spinning sensation where you feel like you're going to fall down.
What is "dizziness"?
Dizziness is a very obscure term. Dizziness can be categorized into four different things. There is vertigo where we actually see our environment spinning around us and that comes from the ear. There is lightheadedness which is caused by either anxiety or hyperventilation where the patient feels like they have a kind of sense of heaviness but they don't see their environment spinning around them. There is disequilibrium which effects older patients where they have problems with their sensation. They may need a cane or walker to keep their balance. The last form of dizziness is syncope which is where everything is black and that is usually caused by vascular or heart problem where your blood pressure becomes very low and the oxygen to the brain is diminished and things go black. These are the four types of dizziness.
What is "motion sickness" or "sea sickness"?
Motion sickness is caused by misinterpretation of the signals between the eye and the ear. When you are, for example, on a ship, you perceive your environment to be fixed, because you're on a large ship, but your ear senses that you're in constant motion. That kind of discontinuity between your visual cue and the balance system in the ear causes you to feel a sick sensation, or motion sickness.
Should I see an otolaryngologist if I experience dizziness, vertigo or motion sickness?
If you experience motion sickness because of a long car ride or because you went on a cruise you probably don't need to see an otolaryngologist if it's fleeting and goes away very quickly. If you're constantly dizzy or you constantly have motion sickness, or you are seeing the environment spin around you, you do need to see an otolaryngologist. If you are dizzy for a prolonged period of time or if you have vertigo for a prolonged period of time you probably need to see your otolaryngologist so they can evaluate your ears to make sure that you don't have either an infection that can cause permanent damage, or that there's nothing like a tumor causing you to be dizzy.
What can I do to prevent or treat motion sickness?
Motion sickness can usually be prevented by one: if it's happening when you are driving in a car, it is usually because you are reading or you are not focusing on your environment. So by simply just looking out of the window and looking at your surroundings, the signal between your eye and your ear will usually balance. On a cruise, there are some over the counter treatments that are either like Antivert or patches that can be placed behind the ear that can decrease your motion sickness. There are some home remedies like ginger tablets that also decrease motion sickness as well. Motion sickness can be treated with patches. Those patches usually contain antihistamine similar to Benadryl. Overall, what it does is it decreases the signals to your brain from your ear and it increases your ability to handle dizziness without you feeling sick or nauseous.
If I consult an otolaryngologist about my dizziness or vertigo, how does he or she diagnose my problem?
The otolaryngologist will make a diagnosis of dizziness based on an examination and listening to the history that you give them. The otolaryngologist will try to define your dizziness as being true vertigo, which would be coming from the ear, or whether your dizziness is related to another problem. If your dizziness is coming from the ear, you'll be sent for a hearing examination as well as vestibular testing, which tests for your balance system in the ear. Based on that information, they can make a diagnosis of vertigo.
What is an "ENG"?
An ENG is an electronystagnogram, which measures your balance. An ENG is very similar to an electrocardiogram, which measure the electrical signals in your heart. The ENG measures the electrical signals that come from the ear to the eye and are used to maintain your balance. If there's any abnormality in those signals, either from one ear to the other or in the whole system in total, that can give a sign as to why you have vertigo.
What is "Meniere's Disease"?
Meniere's disease is a hearing and balance disorder that involves the fluid chambers within the ear. Every person's inner ear has a special fluid that bathes the cells that help to send signals to the brain to keep our balance or to help with our hearing. Meniere's disease is caused by a rupture of the membranes that house the fluid within the ear. When those membranes are ruptured, the electrolyte balance in the system is disrupted and the signals to the brain are changed. Usually the patients experience hearing loss and vertigo as a result of that. Meniere's disease is treatable. Most commonly, dietary modification is used to help treat Meniere's. A low-salt diet can decrease the pressure within the fluid chambers in the ear and help them from rupturing, which is the cause of Meniere's disease.
How are dizziness and vertigo treated?
Vertigo is usually treated with an antihistamine. The antihistamine has an effect of decreasing the stimulus that causes you to feel dizzy. Typically, this vertigo medication can be taken on a daily basis until the symptom is resolved, or over a longer period of time if patients suffer from constant vertigo. Vertigo can also be treated surgically by severing the nerve that's connected to the balance system and relying on your other ear to help take over and balance you out.
How can I reduce or prevent dizziness?
Dizziness can be improved, firstly by making an accurate diagnosis of why you are dizzy. If you are dizzy because of anxiety or a panic attack, then you can be treated with medication to reduce those symptoms. If your dizziness is because of a balance disorder or disequilibrium, assistive devices, such as a cane or a walker, can help with your dizziness. If dizziness is caused from a cardiac or vascular problem, blood pressure medications or heart medications to maintain your blood pressure and the supply of oxygen to your brain will help with your dizziness. Finally, dizziness caused by vertigo which is coming from the ear can be improved by doing some vertigo training exercises. There are special centers which treat patients who have vertigo to help them maintain their balance and use cues in their environment to help with stability. It's not necessarily reversible, but patients learn to deal with the vertigo and adapt in their enviroment. If you have vertigo it's very disabling. If vertigo only involves one ear, the autologist, who primarily treats ear disorders, can sever that nerve, and your other ear will take over and help with your balance. If it involves both ears, obviously that can't be done, and the kind of exercises from a vestigular clinic will help you deal with the balance disorder.
