A sophisticated connection between your brain and the anatomical structure of the inner ear helps you maintain your balance and spatial awareness in your surroundings while sitting, standing or walking. Comprised of tubes and sacs, this gyroscope-like structure is called the vestibular system.
It also contains hair cells and some fluid. Vestibulopathy is the medical term for disorders of this complex structure.
The rare disorder occurs when the balance-regulating portions of both inner ears are damaged. Vestibulopathy can lead to hearing loss and vision problems as well as dizziness and vertigo.
The balance disorder can result from a variety of causes, including infections and head injuries. Ménière’s disease is the most common type of vestibular balance disorder.
First identified in the 1800s, the disease can eventually cause persistent tinnitus or ringing in the ears, and the disorienting sensation that the individual or the surroundings are spinning. The condition ultimately leads to some degree of permanent disability.
Bilateral vestibulopathy occurs when the balance-controlling region of both ears suffer damage. The problem is usually worse at night and in locations with unsure footing. Visual symptoms like oscillopsia, a type of blurry vision, occur when your head is moving. Blurred vision can lead to poor physical coordination. The disorder also causes hearing loss.
In addition to Meniere’s disease and exposure to ototoxic medications, bilateral vestibulopathy can be caused by an infection, ear surgery, and disorders of the immune system as well as congenital disorders. Other risk factors include head injuries and advanced age. Several cases of the condition have no known cause.
The diagnosis of a vestibular disorder usually requires a complete physical examination and comprehensive neuro-otolaryngologic assessments, such as the Romberg, dynamic visual acuity and ophthalmoscope tests. Rotatory chair, caloric, and VHIT test are used to rule out other disorders and confirm the diagnosis. Based on test results, patients are diagnosed as having mild, moderate or severe bilateral vestibulopathy.
Treating the disorder depends on the health care provider’s ability to identify and resolve the underlying cause. Unfortunately, the cause is generally unknown and the damage is irreversible.
In these, cases, vestibular rehabilitation is used to speed recovery, prevent setbacks and lessen future episodes. Exercise-based therapy is designed to improve balance and reduce dizziness and blurry vision. Patients are also instructed to avoid certain medications, such as antihistamines, aspirin, and ibuprofen as well as specific prescription antibiotics. These medications can worsen hearing loss and balance problems.
While medical treatment and occupational therapy can sometimes provide improvement in a sufferer’s quality of life, the potential for frequent falls, the inability to maintain focus and the continual loss of balance may cause permanent disability.
To receive SSDI, the SSA will determine whether your condition meets the agency’s criteria for one of the impairments outlined in the Blue Book. The applicant must have Ménière’s disease or a labyrinthine-vestibular disorder that causes recurrent problems with balance, a gradual loss of hearing and tinnitus.
These basic requirements must be supported by a positional or caloric test showing abnormal functioning of your vestibular labyrinth and a test demonstrating hearing loss.
Because the symptoms of the disorder can fluctuate, vary in severity and temporarily go into remission, it is important that you have medical records fully documenting your illness. The records should include the results of any diagnostic tests, hospital stays and a log of your attacks.