BALANCE DISORDERS (continued)

MENIERE'S DISEASE

Balance disorder caused by large amounts of fluid collecting in the inner ear. In most cases only one ear is affected. Symptoms can be recurring and include vertigo, fluctuating hearing loss, a sensation of fullness in the ear, and tinnitus. Symptoms may change over time and become more severe. Meniere's disease has also been linked to migraine. Attacks of extreme vertigo and other symptoms may last from 20 minutes to 24 hours. Often triggers will precipitate an attack, such as certain foods, changes in pressure, fatigue, anxiety, or other illnesses. The cause of Meniere's disease is unknown. Treatment includes changes in diet, medications, and vestibular rehabilitation. In some cases surgical intervention may be indicated. To reduce the frequency of attacks it's recommended to eat a low-salt, healthy diet, get plenty of rest, exercise regularly, and avoid alcohol, smoking, and caffeine.

PERILYMPH FISTULA

A perilymph fistula is an abnormal opening between the inner ear and middle ear, causing leakage of perilymphatic fluid. Fistulas can occur after head trauma, surgery, changes in atmospheric pressure, and sometimes spontaneously without any apparent cause. Fistulas may also be developmental, occurring before birth. Symptoms include a sudden onset of dizziness, vertigo, and nausea. Complete hearing loss occurs in 50 percent of patients. The only way to diagnose perilymph fistula is through surgery. A fistula may heal itself with bed rest; otherwise surgery may be required.

ACOUSTIC NEUROMA

An acoustic neuroma is a benign tumor on the vestibulocochlear nerve, resulting in a feeling of imbalance, tinnitus, and hearing loss in one ear. Acoustic neuromas are very rare. Microsurgery to remove the neuroma is usually indicated.

MAL DE DEBARQUEMENT

Also known as "motion sickness," Mal de Debarquement translates to "sickness of disembarkment." After certain types of travel the illusion of movement persists after the movement stops. Symptoms are the sensation of swaying, bobbing or floating. Imbalance, disequilibrium and anxiety may also occur. Treatment for Mal de Debarquement is medication and vestibular rehabilitation therapy.

MULTIPLE SCLEROSIS

Multiple sclerosis is a common demyelinating disorder of the central nervous system. Plaque occurs in the brain and spinal cord. There is no known cause. Vertigo and dizziness are common symptoms in patients with MS, and some patients suffer from hearing loss. Other symptoms include visual loss, nystagmus, and dysarthria.