By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S DIZZY SPELLS LIKELY LINKED TO INNER EAR

Question: A couple of weeks ago I had a cold. Then, for a day or so, I was dizzy every time I got up. It is much better now, but I still notice some dizzy spells. I am a basically healthy college student, and none of my friends feel like this. What could be wrong?

Answer: The most common cause of dizziness in otherwise healthy people is an inner ear inflammation, called labyrinthitis. The inner ear is essential in maintaining our balance and spatial orientation. For example, if you spin around in circles, the fluid in your inner ears becomes disturbed, which can create the feeling of dizziness –- like the world is whirling around you. Head colds and sometimes middle ear infections cause inflammation of the inner ear, which similarly disrupts the motion of inner ear fluid and causes dizzy spells, often referred to as vertigo.

The inner ear is also called the vestibular labyrinth. It lies deep inside of your head, behind the eardrum, and consists of three hollow, connected, semi-circular canals. These canals contain a small amount of fluid that moves when you move your head. As the fluid moves, it bends tiny fibers, which send messages to your brain about where and how your head is moving.

Acute labyrinthitis, or inflammation of the vestibular labyrinth, upsets this delicate process. A common theory is that inflammation increases the amount of fluid in the canals, causing excess fluid motion when you move you head and scrambling signals to the brain that create a false perception of movement.

Acute labyrinthitis comes on suddenly and usually starts a week or two following a cold. As you have discovered, it typically comes and goes, and frequently it will heal itself. However, some residual dizziness associated with certain activities may last for several weeks after.

Your doctor would diagnose acute labyrinthitis through taking a medical history and conducting a physical exam. To do so, he or she would move your head in different ways in an attempt to reproduce the dizzy sensation. If there are other factors, like advanced age or a recent head trauma, your doctor may order a head CT scan or other lab tests.

Once acute labyrinthitis is diagnosed, your doctor may suggest medications that help relieve nausea and vomiting, if necessary. If a bacterial infection is causing the problem, prescription antibiotics can help clear it up. Avoiding alcohol and smoking are advisable too. Some people require bed rest or even hospitalization if the dizziness is severe, especially if it causes intense nausea and vomiting.

Normally, the vertigo goes away on its own as either the inner ear inflammation heals or your body adjusts to the confusing signals from the inner ear. Staying physically active can help this adjustment process, known as compensation. Eventually, most people make a full recovery.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.