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18th December 2018

The dizzying impact of an inner ear disorder

When Jennifer Rout had an attack of vertigo on holiday, it turned her world upside down – both literally and figuratively.

Nearly six years later, life is pretty much normal again, but it’s been a long journey. “In January 2013, whilst on a three-week holiday in Australia, I awoke early one morning to the room spinning violently. I could barely find my way out of the bedroom to get to the bathroom where I thought I was going to vomit,” the nanny of 30 years tells This Is MedTech. “The spinning eventually stopped but if I moved my head up or down, even by an inch, the whole room whooshed around.”

Vertigo is a tricky beast. It’s more than just feeling dizzy; it feels like you or everything around you is spinning, enough to affect your balance. Around 80% of patients with this symptom have an inner ear disorder, but it can sometimes be triggered by an underlying health condition or certain medications.

There are many possible causes of vertigo, so diagnosis can be elusive as in Jennifer’s case. “Since it is a part of the body that is impossible to get to, it is hard to make a firm diagnosis,” she explains. However, tests like computed tomography (CT or CAT) and magnetic resonance imaging (MRI) scans can help doctors rule out certain conditions.

The first doctor Jennifer saw suspected benign paroxysmal positional vertigo (BPPV) which is the most common cause of vertigo and occurs when microscopic crystals get into the wrong part of the inner ear. Nine times out of ten a head-movement technique called the Epley Manoeuvre relieves symptoms, but for Jennifer “it caused horrendous spinning again that was hard to stop”.

She was then given various medicines, but for the next few weeks she couldn’t lie down or move her head, in addition to having constant ringing in her ears (tinnitus). After that, Jennifer went to an ear, nose and throat (ENT) specialist who diagnosed labyrinthitis, an inner ear infection that was “possibly from a water-borne virus that I’d picked up from swimming in the harbour the day before”. Audiology testing showed hearing loss, and Jennifer was told that she’d need hearing aids.

“My ears still felt ‘full’ and I had constant nausea, so I was also given a strong course of steroids and diuretics to reduce fluid levels, in case it was Ménière’s disease,” a rare inner ear condition involving a build-up of fluid. Unfortunately, Jennifer further deteriorated to the point of being unable to eat or move. “I was admitted to hospital with severe dehydration and given a CAT scan to rule out a stroke,” she says. After being discharged from hospital, Jennifer underwent an MRI with dye, which led to the diagnosis of vestibular neuronitis, an infection of the vestibular nerve in the inner ear.

Although vertigo is commonly experienced and rarely a symptom of something serious, it can have a huge impact on your daily life. “I remember telling one of the doctors in hospital that they had to help me feel better or I couldn’t carry on,” recalls Jennifer. “I felt hideously nauseous 24 hours a day and still couldn’t move much. I had to sleep completely upright with a neck brace on to prevent movement.”

She’s eternally grateful for some amazing friends in Sydney who looked after her until she was well enough to fly back to the UK six months later, as well as phone calls and emails from friends and family at home which boosted her mental state.

Once home, Jennifer needed to take some time off work to recover “as I was still experiencing dizziness in certain positions and couldn’t risk the safety of any infants in my care. This led to a loss of confidence in my abilities as I was unsure whether I would ever be able to work again and really worried about what the future would hold,” she notes.

After undergoing further tests in the UK and getting hearing aids, Jennifer was referred for cranial osteopathy as well as an exercise-based programme called vestibular rehabilitation.  She’s also found that joining a gym and trying different classes have helped immensely.

“At first I told each instructor at the beginning of the class that I wasn’t able to lie down but gradually I started doing it as I was distracted by the exercises and therefore not scared about attempting that position. I’ve had a few minor wobbles during class but nothing too bad,” she comments. “I can’t drink too much alcohol anymore and I avoid fairground rides and playground equipment like roundabouts and swings but generally, life is back on track.”

To learn more about vertigo, as well as the different types of vestibular disorders and ongoing scientific research, visit the Ménière’s Society and NHS websites.