Autoimmune Inner Ear Disease AIED Symptoms and Treatment

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Autoimmune Inner Ear Disease AIED Symptoms and Treatment

Autoimmune inner ear disease is an uncommon condition in which the immune system assaults the inner ear by mistake.

It can make you dizzy, induce ringing in your ears, and make you lose your hearing. AIED affects less than 1% of the 28 million people in the United States who have hearing loss. It is significantly more common in women in their forties and fifties. Symptoms Hearing loss in AIED begins in one ear and subsequently progresses to the other.

This can happen in weeks, or it can take months. Other signs and symptoms include dizziness and balance issues. Tinnitus (ringing, hissing, or buzzing in the ear) and dizziness (feeling like you are spinning) causes your immune cells to look for microorganisms attempting to infiltrate your body constantly. They target cells in your inner ear when they mistake them for a virus or bacteria. It is referred to as an autoimmune response. Other organs can be harmed by immune cells.

Rheumatoid arthritis, lupus, scleroderma, ulcerative colitis, or Sjogren’s syndrome afflict over 30 per cent of persons with AIED (dry eye syndrome). The symptoms of AIED are so frequent that diagnosing it can be difficult.

Until the hearing loss has extended to the second ear, it is frequently misdiagnosed as an ear infection. Doctors will perform a physical examination, and run through a hearing test to diagnose AIED. They will also do a balance test, which will reveal how well your inner ear “communicates” with your brain. A blood test is also possible. No test can definitively determine whether or not you have AIED, but the results may indicate that you are experiencing an autoimmune reaction.

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If this is the case, you should look for treatment from an ENT specialist knowledgeable about autoimmune illnesses. Because you may not receive a firm response, your doctor may begin therapy without a definitive diagnosis to avoid irreversible hearing damage. Many people aren’t identified with AIED until their symptoms improve after they start treatment.

Balance Disorders Causes Types Treatment NIDCD

What does it mean to have an issue with balance? A condition that causes you to feel unsteady or dizzy is called a balance disorder. You can feel like you’re moving, whirling, or floating whether you stand, sit, or lie down. You can feel as if you’re about to fall over when walking. Everyone experiences dizziness at times, yet the term “dizziness” can signify different things. Dizziness can range from a brief fainting sensation to a severe, long-lasting case of vertigo.

In 2008, about 15% of adults in the United States (33 million) reported having a balance or dizziness issue. Certain medical illnesses, drugs, or a problem with the inner ear or brain can all contribute to balance issues. A balance impairment can make daily activities challenging and lead to mental and emotional issues. How can you know if you have a balance problem? It’s possible you may notice the following signs and symptoms if you have a balance problem.

Light-headedness or dizziness (a feeling of spinning). It was falling or anticipating a fall. When you try to walk, it’s a stumbling block. Feeling dizzy, faint, or floating, Vision is blurred. Confusion or disorientation are two words that come to mind when someone mentions confusion or disorientation. Nausea and vomiting, diarrhoea, changes in heart rate and blood pressure, as well as fear, worry, or panic, are all possible symptoms. Symptoms may appear and disappear in short periods of time or may last for a long time, causing exhaustion and depression.

What causes balance disorders?

Medication, ear infections, head injuries, and other things that impact the inner ear or brain can cause balance problems. If you stand up too rapidly with low blood pressure, you may experience dizziness. Disorders can also cause balance issues with the skeletal or visual systems, such as arthritis or an imbalance in the eye muscles. With age, the likelihood of experiencing balance issues rises. Unfortunately, many balance issues strike without warning and an apparent reason.

How does my body keep its balance?

The feeling of balance is based on a succession of signals from numerous organs and structures in the body, particularly the eyes, ears, muscles, and touch sensors in the legs, which are sent to the brain. The vestibular system, is often known as the labyrinth, is a maze-like structure of bone and soft tissue in the inner ear that controls balance and movement. Vestibular system structures of the inner ear NIH/NIDCD (National Institutes of Health/National Institute of Diabetes and Digestive and Kidney The arcuate ducts are structures found within the labyrinth. Three fluid-filled channels form loops in the arcuate ducts, which are positioned at almost right angles to each other. When the head turns, they send a signal to the brain. The cupula [KEW-pyew-lah], a gelatinous structure that stretches like a thick sail and closes off one end of each canal, is found inside each canal.

A cluster of sensory hair cells sits on top of the cupula. Stereocilia are small, slender projections that extend into the cupula from each hair cell. The fluid in the arcuate moves when you turn your head, causing the cupulae to bend or undulate like sails in the wind, which bends the stereocilia. This bending sends a nerve signal to the brain, informing it of the direction in which the head was twisted. Two otoliths [oh-toe-LITH-ic]: fluid-filled sacs termed the iriticle [YOU-trih-cull], and the saccule [SACK-kewl] is located The cochlea is placed between the semicircular canals and the semicircular canals (a snail-shaped, fluid-filled structure in the inner ear).

These organs communicate to your brain your head’s position concerning gravity, such as whether you’re sitting, reclining, or lying down, as well as any movement your head makes, such as side to side, up or down, forward or backward. Sensory hair cells line the floor and wall of the utricle and saccule, with stereocilia extending into a gel-like layer above. Otoconia [oh-toe-CONE-ee-ah] are small, thick calcium carbonate grains found in this gel. Gravity pushes on these grains regardless of your head’s position, which causes the stereocilia to shift, signalling your brain’s position. Each movement of your head sends a signal to your brain, informing it that the location of your head has changed.

Your vestibular system senses mechanical forces, such as gravity, that stimulate the arcuate and auricular organs when you move. To govern the position of your body at rest or in motion, Other sensory systems in your body, such as eyesight and the musculoskeletal sensory system, work with these organs. When you walk or run, this helps you maintain a steady posture and balance. It also assists you in maintaining visual focus on objects as your body moves. If any of these sensory system signals are interrupted, you may feel problems with your sense of balance, including dizziness or vertigo.

You may also lose your capacity to effectively recover from an imbalance if you have problems with motor control, such as weakness, slowing down, tremors, or stiffness. Falls and injuries are more likely as a result of this. What are some of the different kinds of balance disorders? Balance issues come in a variety of shapes and sizes. The following are a few of the most prevalent.

A brief, acute episode of dizziness induced by a specific change in head position is BPPV, often known as positional vertigo, which is a type of benign paroxysmal positional vertigo. When you bend over to check under something, angle your head to gaze up or over your shoulder or turn over in bed, you may feel as if you are spinning. BPPV is caused by loose otoconia invading one of the arcuate ducts and interfering with the cupula’s function. This hinders the cupula from bending properly, causing vertigo by sending inaccurate information about the head position to the brain. BPPV can arise as a result of a head injury or as a result of ageing.

Labyrinthitis: Dizziness and balance issues are caused by an infection or inflammation of the inner ear. It frequently happens in the context of an upper respiratory infection like influenza. Dizziness, hearing loss, tinnitus (a ringing or buzzing in the ear), and a feeling of fullness in the ear are all symptoms of Ménière’s illness. It could be linked to a change in fluid volume in certain sections of the labyrinth, although the cause(s) are unknown. Ménière’s disease is described in detail on the NIDCD information page Ménière’s disease.

Vestibular neuronitis: An inflammation of the vestibular nerve that can be caused by a virus, and primarily causes vertigo.

Perilymph fistula:

The middle ear is leaking fluid from the inner ear. It produces restlessness, dizziness, and nausea, which frequently worsens with activity. A perilymph fistula can develop after a head injury, dramatic changes in air pressure (e.g., scuba diving), physical effort, ear surgery, or recurrent ear infections. A perilymph fistula is a condition that some people are born with. MdDS (Mal de Debarquement Syndrome) is a sensation of constant rocking, swaying, or rocking that occurs after a cruise or other maritime excursion, or even after lengthy treadmill jogging. Symptoms usually disappear after a few hours or days of reaching land or ceasing to use the treadmill.

On the other hand, severe cases might linger for months or even years, and the reason is unknown. What are the methods for determining whether or not a person has a balance disorder? A balance issue is challenging to diagnose. Your care physician may refer you to an otolaryngologist and an audiologist to determine if you have a balance problem. A physician and surgeon who specialises in diseases and disorders of the ears, nose, throat, and pharynx is known as an otolaryngologist. A specialist who specialises in the function of the auditory and vestibular systems is known as an audiologist. To remove otoconia, the Epley manoeuvre is utilised. A hearing test, blood tests, a videonystagmogram (a test that analyses eye movements and the muscles that govern them), or imaging scans of your head and brain may all be performed on you.


A posturography is another possible test. In this test, you stand in front of a patterned screen on a customised moving platform. Posturography is a test that determines how well you can maintain your balance in various situations, such as standing on a stationary moving surface. Other tests, such as swivel chair tests, vigorous head shake tests, or even tests that evaluate the response of the eye or neck muscles to brief clicking sounds, may be done. Because the vestibular system is so complicated, many tests may be required to pinpoint the source of your balance issue.

How are balance disorders treated?

An ENT specialist will initially see if another ailment or medication is to blame for your balance issues. Your doctor will either address the issue, prescribe an alternative medication, or refer you to a specialist if the condition is beyond their scope of practice. If you have BPPV, your otolaryngologist or audiologist may perform a series of simple manipulations, such as the Epley procedure, to liberate the otoconia from the archway. A single session is often enough; however, for some people, the treatment must be repeated several times before vertigo disappears.

If you’ve been diagnosed with Ménière’s disease, your ENT specialist may advise you to adjust your diet and, if you’re a smoker, to quit. Dizziness and nausea medications may help you feel better, but they might also make you sleepy. Other drugs may be utilised, such as gentamicin (an antibiotic) or corticosteroids. Although gentamicin reduces dizziness better than corticosteroids, it can cause irreversible hearing loss in some people.

The vestibular organs may need to be operated on in some severe forms of Ménière’s illness. Some patients with vestibular disorders are unable to eliminate their dizziness and must develop coping mechanisms. A vestibular rehabilitation therapist can assist you in creating a therapy plan that is specific to your needs. Please consult your doctor about whether it’s safe for you to drive and how to limit your risk of falls and injuries while doing routine activities like walking up or downstairs, going to the toilet, or exercising. To limit the risk of harm caused by dizziness, avoid walking in the dark. When walking outside, wear low-heeled or walking shoes.

If required, use a cane or walker. and make changes to your home and work surroundings, such as building railings. When should I get help if I think I’m having trouble with my balance? · Determine whether you should see a doctor for dizziness or balance problems, ask yourself the following questions. You should see your doctor if you replied “yes” to any of the following questions:

Do I feel unsteady?

Do I get the impression that the room is whirling around me, even if it’s only for a few moments? Even if I’m sitting or standing still, do I feel as if I’m moving? Will I lose my footing and fall? Do I feel as if I’m about to fall? Do I feel nauseous or as if I’m about to pass out? Is there something wrong with my vision? Do I ever feel bewildered, as if I’ve lost track of time or location? What can I do to assist my doctor in making a diagnosis? By answering the following questions, you can assist your doctor in making a diagnosis and developing a treatment plan.

Prepare to discuss this information with your doctor during your visit. My dizziness or balance issue is best described as follows: Is there a spinning sensation, and if yes, which way does it spin? Does a specific movement induce the dizziness/twisting, or does it happen whether I sit or lie still? Are there any other symptoms, such as hearing loss, tinnitus, a sense of pressure in one or both ears, or headaches, that co-occur as dizziness? Is there anything that can help with the spinning and dizziness? How frequently do I become dizzy or lose my balance? How long do dizzy or spinning episodes last (seconds, minutes, hours, days)?

Is this the first time I’ve fallen? When did I lose my balance? What happened to me? What were the circumstances of my fall? I’ve been knocked down so many times I can’t count. These are the drugs that I take. List all prescription and over-the-counter medications, including aspirin, antihistamines, and sleeping pills, as well as any vitamin supplements and alternative or homoeopathic remedies: Drug or supplement name. How much (milligrams) and how many (times) per day do you take? I’m taking this medication to treat the following issues. What kinds of studies on vestibular diseases are being conducted?

Animal ears are being studied by scientists funded by the National Institute on Deafness and Other Communication Disorders (NIDCD) to discover if inner ear components that improve balance that is lost due to age, medicines, infections, or trauma could one day recover in people with balance disorders. Other NIDCD-funded researchers are testing vestibular prostheses, which are small devices that can be worn on the outside of the body or implanted in the ear to control the operation of the inner ear’s balance organs and treat dizziness.

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