In my last article I wrote about BPPV (Begin positional proximal vertigo), the most common cause of vertigo. Probably the next most common cause is vertigo caused during or after an inner ear infection.
There are some significant differences between these two diagnoses: BPPV is a vertigo which is bought on by a change of position such as rolling over in bed or moving from sitting to standing. Another notable difference is that BPPV produces a true vertigo meaning that the room will be spinning around you. Whilst BPPV can produce very strong symptoms, it lasts for short bursts of about 30 seconds and then settles down, until you move position again. In the majority of cases this can be resolved with a simple repositioning manoeuvre in one session.
Dizziness induced during or after an ear infection is often slightly different. The first difference of course is the history of an ear infection. During the initial stages you should seek help from your GP, as getting the infection under control in this initial stage is going to be of the most help. It can sometimes be difficult to link dizziness to an ear infection that happened a long-time ago, but I find that it is not uncommon for someone who suffered with ear infections when younger to start to report these feelings many years later. Whilst it can be difficult to link an old infection to dizziness, it is possible to do some in-office assessments that would point to this being the most likely cause of dizzy symptoms. There are some simple bedside tests that will indicate if the output from a vestibular nerve has been impaired and more in-depth assessments that can help to rule out other causes of dizziness.
Why do ear infections cause dizziness?
When you have an inner ear infection it can affect both the cochlear and vestibular portions of the eighth cranial nerve and if it affects the vestibular part this can result in dizziness or more often a sense of wobbliness sometimes a long time after the initial infection.
The vestibular nerve sends information from the semi-circular canals in the inner ear to other parts of the brain and has a direct link to eye movements. If its function has been impaired the eyes may not move with the correct coordination and you can experience this as dizziness, wobbliness or sense of not being quite sure where you are in your environment.
For many people this feeling will resolve naturally after recovering from the initial infection for others it will not. It is also possible for it to take a long period of time, sometimes decades after the initial infection, before symptoms appear. The reason for this is that an infection can often cause a reduction in functional ability of the vestibular nerve in the affected ear and as we age or have other issues impacting the vestibular nerve symptoms can start to appear.
Unlike BPPV, dizziness cannot be corrected by one simple manoeuvre but it can be improved and resolved with some specific, focused rehabilitation exercises.
These exercises are focused on re-integrating the complex brain pathways that help you to understand where you are in the world. They do often take some time to completely resolve the issue but they are simple to do and effective. Often there will be complete resolution of symptoms in one to two months.
Eoin Roe is a Chiropractor and Functional Medicine Practitioner based in Skibbereen, please feel free to contact him through the website www.roehealth.ie or call on 028 62081 and leave a message.