Can anyone identify this inner ear condition by the test?

Meniere’s Disease? First thing that popped into my head.

Meniere’s Disease is a possibility. However, it is accompanied by hearing loss and a ringing or other sensation in the ears.

There is also something called BPPV (Benign Paroxysmal Positional Vertigo), which is what I was just diagnosed as having. I, too, was given eye exercises to do. Mine are to stare at an x on a piece of paper and then turn my head from left to right and back 10 times without taking my eyes off the x. Next I do the same but move my head up and down. This apparently retrains my eyes in some way that is supposed to help.

The above are the two most common causes of vertigo. My father, grandfather and great grandfather were all diagnosed with Meniere’s Disease, and they all had hearing loss and tinnitus. I don’t really have much hearing loss and I only rarely have ringing in my ears.

There is a brief discussion of the two problems here with more details as to what precisely in happening. My therapist seems to think that they may be variations of the same problem, with BPPV being the mild form and Meniere’s Disease being the severe and chronic form.

@DrasticDreamer That’s what I thought of. My Grandfather has it.
@BraveWarrior If it is Meniere’s, it’s usually treated by monitoring the intake of substances that affect the body’s water levels (i.e caffeine and sodium,) by maintaining a low level of these, or avoiding them entirely.

I would ask @HearCat. She’s an audiologist.

Thank you all for your replies to my first post. I did a search for Meniere’s Disease and I don’t think that’s it as we all have good hearing and no ringing or feeling of fullness in the ear and symptoms aren’t that severe. @Darwin I think Benign Paroxysmal Positional Vertigo sounds like a very good possibility although when I looked BPPV online, websites all say the Dix-Hallpike test is used to diagnose it & that isn’t the air in the ear test. However, what I read in Wikipedia here http://en.wikipedia.org/wiki/Benign_paroxysmal_positional_vertigo matches the symptoms and your post sounds like my sister’s eye exercises.

For BPPV, which I have had, the Dr. will do some nasty head twists in his office called Epley manoeuvers, which shake the little loosened particles back where they belong.

Always avoid having your hair washed at a beauty salon and being jerked back in a dental chair. I wash and condition my hair in shower at home before cut, and at the dentist’s, we have a routine to lower the chair, with me in it, very gradually.

Get out of bed mindfully. Roll on side, place feet on floor, think good thoughts for a minute or two and then stand up.

This does not sound like M’s disease. The tests I had were cold and warm air, cold and warn water and following little lighted spots on a screen. I felt so rotten afterwards that I had to lie on the table (making the room unusuable for other patients) for over an hour before I could sit up and wobble.

Here are the home exercises, buried among all the other info.

Woot for Gail. But stop stealing my business. ;-)

@pdworkin: Thanks for the reference (it’s spelled with a “k”). Yes, I am an Audiologist, and I have had BPPV twice.

@BraveWarrior: As you have already surmised, Meniere’s Disease seems unlikely as you describe your symptoms. @Darwin: I have not heard others theorize that Meniere’s and BPPV are related, and I personally don’t suspect that they are.

BPPV is a spinning sensation that occurs only when you move your head a specific way, and resolves within seconds once you are still. If your symptoms differ from this very specific description, it is probably not BPPV.

The Epley Maneuver, as mentioned by @gailcalled, aims to reposition debris in the semicircular canals of the inner ear, so they will no longer cause an over-reaction to movement by shifting the fluids too rapidly. The ‘eye’ exercises, as described by @Darwin, may be a variation on that process, since it involves repetetive head movements. The first time I had BPPV, I actually was doing oblique twists which accidentally served the same purpose for me.

Generally, if eye exercises or physical therapy are involved, the source of the dizziness or imbalance is more likely to be in the central nervous system and/or sensory-motor system.

The ENG/VNG is the test performed to evaluate the vestibular system. The patient wears goggles and/or electrodes around their eyes, and the computer tracks eye movements in response to visual stimuli, positional changes (including the Dix-Hallpike), and temperature changes in the ear (calorics – which might use air or water to induce the temperature change).

No one likes the sensation of being dizzy; but the best way to determine the specific cause of your symptoms is to challenge your system. I always advise patients that we do help you stop any dizziness we cause, and the more relaxed you can be, the more accurate our results are.

@hearkat – Neither have I, but this one therapist seems to think so. Why I do not know.

@gailcalled @Darwin @hearkat
Thank you for your detailed replies! I spoke with my sister & she said she had the warm and cold air as well as the lying on the table and googles tracking her eye movements tests so we’re pretty sure that she & our dad were diagnosed with BPPV based on your descriptions – thanks very much!!! The only thing is that my dizziness is not always preceeded by a change in position (as far as I know)... sometimes it will happen after I’ve been working on the p.c. for a while or every once in a while walking on the treadmill. Interesting, though, @hearkat that you’ve said you’ve had it twice… my sister’s ENT told her basically nothing could be done to “fix” it although the eye exercises could help to “reset” it & make it better.

@BraveWarrior: There are different theories on the exact cause of BPPV, and with current technology, there is no way to know with certainty what is true. The problem with ear disorders, and diagnosing or even researching them, is that the strictures of the ear are so tiny and delicate that we can’t see most of the mechanisms with current imaging techniques. So all we can do is formulate theories based on symptoms and reactions to treatments; and we use tests like the ENG/VNG to narrow down the possibilities based on how your eyes and inner-ears coordinate to different stimuli.

Yes, true BPPV can reoccur as it did for me. The first time I had it was about 10 years ago, which was when I ‘cured it’ accidentally while doing oblique twists. The fact that I didn’t follow establishe treatment protocol like the Epley Maneuver may attribute to why it returned within a few years. The second time around, I did follow the Epley protocol, and it has been several years without any vertigo. I am fully aware that there is a chance that I could get it again, but I am not letting that stop me from leading an active lifestyle.

@hearkat Maybe I’ll try the Epley Maneuver since I can’t imagine it would hurt anything. Just that my mini episodes of vertigo don’t happen too often & seem to be “without rhyme or reason” so unless I were able to keep some sort of journal, I don’t know if I’d know if they were really helping. I have had normal EEG, CT-scan, & MRI in the past so don’t think it is anything more serious and it isn’t really affecting the quality of my life… I just know that I have to have a “death grip” on the treadmill & look down & focus on the moving part every once in a while, sit in a chair with arms (that I can grab onto) if I’m going to be on the computer for a while, and I have to hold onto the rail if available or the wall if no rail when inside an elevator, just in case.
Thanks again! I am finding Fluther & the Flutherites to be a very helpful resource!!!

@hearkat I asked my sister if she thinks it was BPPV and she replied “I think it was called a ‘bilateral something imbalance…’” But the tests & exercises she told me sound like the same for BPPV so I’m wondering if perhaps they’re 2 different descriptions for the same thing?

@BraveWarrior: Without the exact diagnosis, I couldn’t say. BPPV typically is limited to one side – unilateral. Did they also recommend a low-sodium diet or potassium supplements for your sister?

@BraveWarrior: Now that you have eliminated the horrible things (like brain tumors) with the EEGS, CT’s, and MRIs, check out the very different tests for vertigo; there are several fancy names for it. This is done by an ENT in his office. The Epley manouevers also have to be done by Doc.

You do sound as though your balance problems are related to the inner ear. That can be improved, if not cured.

@BraveWarrior: I’ve just gone over your posts again, and based on the fact that you are experiencing the dizziness while on the treadmill or sitting at the computer or on an elevator, it does NOT sound like BPPV. As I mentioned before, BPPV is a fleeting spinning sensation that occurs with very specific head movements.

Your symptoms, and the fact that your sister was told that the diagnosis was bilateral, and that the eye exercises were described as a way to “reset” the system, suggests that the vestibular system of the inner ear and the information being sent by the eyes and body (somatosensory system) are not coordinating well.

When in an elevator, the eyes and body are stationary, but the ears are sensing movement. On the treadmill, the eyes see stationary objects, but the boy and ears are sensing movement. If the vestibular system is a bit hyper-sensitive, this mismatch could make you nauseous and woozy – basically you are getting seasick (do you or other family members have a history of motion sickness?).

The idea of fixating your gaze on a stationary object while moving your head is designed to strengthen the coordination between the eyes and the ears, because your body and eyes are still, but your inner ears are getting stimulated through the head movement.

Again, I will stress that this is speculative, and the best way to know what your specific diagnosis is, is to have it comprehensively evaluated. In addition to the ENG/VNG, the posturography and rotary chair tests might provide additional information to which specific system is the weakest link.

@hearkat Thank you, again I appreciate your detailed reply. Yes, both my sister & my father get motion sickness. My father used to say he would even get motion sickness if someone other than he drove, although I always thought that was because he didn’t want any one else to drive (he was a bit of an aggressive driver). I will only get car sick if I am looking down while in the car – as a passenger if I want to read something, I have to look up every few moments. Had been on a “cruise to no-where” with hubby a few years ago (just out into the bay & back dinner cruise) and when the boat pulled out of the dock my hubby said my face went white. As we were going along the pier, I had to keep looking out the window and looking at the houses go by for about a good 20 minutes before the motion sickness (nausea & sickness) would stop, but then after that, was fine the rest of the cruise! Was like my body/eyes/brain had to sync up with the boat’s motion (?)
Not really enough to affect the quality of my life too much, but maybe I will bite the bullet & schedule an ENT appt for 2010 since hubby & I want to do a cruise to Bermuda within the next 2 years and I wouldn’t want to be sick the entire time!
Thanks again!

You’re welcome! I hope you get useful answers and helpful treatment!!