This is the most common cause of vertigo.

 

I see patients frequently for balance issues and vertigo and want to address the most common cause.  Often, patients will complain that they had sudden onset of vertigo, lasting up to a few days.  They will often be seen in the ER or by their primary doc.  Sometimes they will be told that they had an infection and get some antibiotics or sometimes steroids.  

The vertigo fades but patients often then are left with symptoms of imbalance, dizziness, or even a feeling of vertigo, especially with quick movements.  Sometimes this will persist for weeks or even months after the initial, severe attack. 

So this is best understood if we compare your balance system to a two engine airplane. 

An airplane needs relatively equal thrust from each engine to fly well.  Our balance system also needs equal input from each of the inner ear organs (called the “labyrinth”) to keep us upright. 

When we suffer an initial onset of vertigo, the most common cause is a viral inner ear infection, called labyrinthitis. A very similar infection occurs in the nerve from the inner ear to the brain, called vestibular neuritis. They are functionally the same thing.  

So consider this infection like an airplane that has had something go terribly wrong to one engine, like an engine fire.  The pilot would immediately cut off fuel to the engine so that the plane wouldn’t explode.  Now the plane only has one good engine.  It can fly, but not very well.   In a similar fashion, for a period of time, after an inner ear infection, the affected inner ear doesn’t send as much signal to the brain (kinda like an plane’s engine that has been shut off).  Now, our balance system is only working with one “good engine”.  We can still function, but not as well.  This can last weeks, but sometimes months, as the inner ear slowly is slowly repaired.  

So, what do we do about this?  Sadly, medications don’t really help.  A commonly prescribed med, called Meclizine, doesn’t help balance.  It can help reduce severe vertigo and nausea, but usually it just helps that and makes patients sleepy.  People don’t typically want to be sleepy all day.  They want to be able to “get back to normal”.  There isn’t a medication that does that. 

What really helps is physical therapy for the balance system.  This is called “vestibular rehab”. 

This can really make a big difference is restoring normal function to the balance system and getting back to a normal life. Check out these exercises to help improve balance here.

 

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Daily Life, EarErin Shellenbergerbalance, vertigo, dizziness, ear infection, ear