What Are the Treatments for Vestibular Disorders?

Vestibular disorders are disturbances of the inner ear network called the vestibular system. Along with vision and sensory input from muscles and joints, this system is responsible for providing the information needed to maintain proper balance. Disruptions of inner ear function can cause significant physical disorientation, and at their extreme they are debilitating. Treatments for vestibular disorders vary according to the particular problem present.

Understanding and Treating Benign Paroxysmal Positional Vertigo

• Benign paroxysmal positional vertigo (BPPV) is a common disorder caused by the presence of tiny calcium carbonate crystals in the inner ear. These crystals, also called otoconia, shift with head movements and trigger false, disorienting signals to the brain. If you have BPPV, your primary symptom will be dizziness associated with changes in head position. Treatment for the disorder frequently involves physical removal of otoconia through an ear canal. Typically, you will undergo this short procedure in your doctor's office. Physical removal may be accompanied by physical therapy to retrain your brain's interpretations of motion signals. In a few cases, surgical blocking of an affected ear canal is necessary.

Understanding and Treating Meniere's Disease

• Meniere's disease is caused by abnormal buildup of an inner ear fluid called endolymph. It frequently affects both ears. If you have Meniere's disease, your symptoms may include intermittent hearing loss, severe vertigo (spinning) and painful ringing in the ears (tinnitus). In advanced cases, you also may experience stronger tinnitus, increased hearing loss and continual difficulties with balance and vision.

  Medication is frequently used to combat Meniere's disease. Your doctor will attempt to lower pressure in your inner ear through use of diuretics and will ask you to reinforce treatment through a low-sodium diet. In order to diminish sometimes debilitating symptoms, you also may receive dimenhydrinate (Dramamine), diazepam (Valium) or promethazine (Phenergan). Physical therapy also may be used for retraining.

  In some cases, your Meniere's symptoms may be severe enough to require a labyrinthectomy, a procedure in which chemical injections are used to destroy abnormal vestibular tissue. In extreme cases, surgery may be needed to destroy the affected vestibular nerve or inner ear.

Understanding and Treating Neuritis and Labyrinthitis

• Vestibular neuritis and labyrinthitis are caused by infection of the vestibulo-cochlear nerve in the inner ear. Neuritis affects one branch of this nerve; labyrinthitis affects both. Symptoms of these disorders include sudden severe dizziness, nausea, vomiting, unsteady balance and visual disturbances. Labyrinthitis also may cause hearing loss or tinnitus.

  If you have either one of these conditions, you will receive medications for symptom control similar to those used for Meniere's disease. Additional medications may include anti-viral drugs and corticosteroids. If you have a middle ear infection, you also will receive antibiotic treatment. Dizziness from neuritis and labyrinthitis can linger for months. If you experience persistent dizziness, your treatment may include vestibular physical therapy.

Additional Disorders

• Your vestibular difficulties also may be caused by a number of additional disorders, including acoustic neuroma, vestibular migraine, ototoxicity (toxin damage), auto-immune problems and aging. Because similar symptoms can have different causes, you will need to see an ear specialist for proper diagnosis. Your treatment will be based on the results of your doctor's findings.