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Vertigo is one of the four main categories of dizziness. As dizziness arises when the delicate relationship between the inner ear, eyes, and the brain is damaged, your ear health and vertigo are more connected than most people think.
This article will explore the connection between vertigo and hearing loss, as well as your options for treatment.
What Is Vertigo?
Vertigo is a form of dizziness, or a balance problem, where it feels like everything around you is spinning. It can occur in attacks lasting from a few seconds to hours. However, if you suffer from severe vertigo, you might be affected for days or months at a time.
As balance issues are largely caused by problems of the inner ear, this is a likely cause of your vertigo.
Usually, vertigo gets better on its own without treatment. However, you should see your doctor if you have it constantly, it keeps coming back, or it's affecting your daily life.
Hearing Loss and Vertigo - How Are They Connected?
Your eyes, inner ear, muscles and joints send signals to your brain, helping things to run smoothly.
In the inner ear, hair cells send information to your brain through the acoustic nerve which is then used to help you know where you are in space. This helps you to keep your balance. When things go wrong due to injury, disease or infection, people often experience balance problems such as dizziness and vertigo.
Not everyone with balance disorders suffers from hearing loss, and not all people with hearing loss struggle with their balance. However, it is not uncommon for them to occur together.
Causes of Vertigo
Inner ear problems are usually at the root of vertigo symptoms, as they affect your balance.
Vertigo causes related to the inner ear issues include:
- Ménière's disease - a rare inner ear condition, which sometimes involves ringing in the ear (tinnitus) or loss of hearing
- Labyrinthitis - an inner ear infection caused by a cold or flu virus
- Vestibular Neuronitis - inflammation of the vestibular nerve
- Benign Paroxysmal Positional Vertigo (BPPV) - sensitive crystals in your ear become dislodged
Other causes of dizziness include:
- Migraines
- Some medications (as a side effect) or ototoxic drugs
- Blood pressure changes
- Viruses and infections
- Issues with how blood moves around your body
- Objects in the ear canal
- A hole (fistula) in your eardrum
- Multiple sclerosis
- Vision problems
- Tumors on the hearing nerve (acoustic neuroma)
- Head injury (traumatic brain injury)
- Perilymph fistula (when fluid from the inner ear leaks into the middle ear)
Often the exact cause of vertigo is unknown.
Vertigo Treatment
There are a few things you can do to ease your vertigo and reduce the frequency of your episodes. When you have an immediate bout of vertigo, it's advisable to lie still in a dark, quiet room to reduce the whirling feeling, or if this isn’t possible, sit down straight away when you feel dizzy. More generally, try to relax as much as you can. Anxiety is known to make vertigo worse, so managing your stress will contribute to keeping your symptoms under control.
Most cases get better without medical treatment, but if you have constant vertigo, are experiencing frequent attacks, or you’re feeling like it's beginning to impact your quality of life, you should make an appointment with your doctor. They will be able to ask you about your symptoms and hopefully figure out the cause of your vertigo.
They might give you some special balance-correcting exercises to do, and if they're unsure about the cause of your vertigo or need a second opinion, they'll refer you to a specialist for further tests. The most appropriate treatment will depend on the cause of your vertigo.
If it's clear that it's caused by an infection, your doctor will prescribe you antibiotics. Antihistamines (such as cinnarizine, cyclizine, or promethazine) work by blocking histamine and are often used for symptoms of nausea and motion sickness, so these might be able to help with your vertigo symptoms. If you have a severe feeling of sickness, you might be prescribed prochlorperazine to help with this.
Should I Be Worried If I Have Vertigo and Hearing Loss?
If you have vertigo and hearing loss, this might be caused by one of the conditions below. If you’re experiencing any of these symptoms, it's important to see your doctor for a diagnosis. It's only when the cause of your symptoms is known that the severity of your case can be fully understood.
If treatments don't work for you, there are still balance disorder exercises (Vestibular Rehabilitation Therapy) that effectively help people control their symptoms.
Ménière’s Disease
Ménière’s disease is a long term, progressive condition. It affects the balance and hearing parts of the inner ear. You might experience symptoms such as acute episodes of vertigo (the major symptom), tinnitus, deafness (which often gets worse), and pressure in the ear. It can affect anyone at any age, although Ménière’s disease runs in the family for about seven to 10% of sufferers.
It is thought that Ménière’s disease develops due to an increase in pressure in the endolymphatic space. This helps to explain the symptoms of ear fullness and reduced hearing, and the sudden release in pressure accounts for the sudden attacks of vertigo. This cumulative damage from the pressure changes results in an increased hearing loss over time.
Treatment aims to control symptoms and includes medication, vestibular rehabilitation, tinnitus management, hearing aids, counseling, diet and lifestyle changes, and sometimes surgery.
Positional Vertigo
Benign Paroxysmal Positional Vertigo (BPPV) is a very common cause of vertigo and happens when you move your head in certain directions.
BPPV occurs when small crystals in the inner ear move from their correct position in the balance organ, collecting in another part of the ear as debris. When you move your head, these loose crystals move too, sending false information to your brain about your movements.
Interestingly, around 20% of all dizziness is due to BPPV, and 50% of dizziness in older people is due to BPPV. It can still affect young people, although it will likely be caused by a head injury.
The reason BPPV occurs is often unknown.
A particle-repositioning maneuver is used as part of the treatment to return the debris to the correct position, which is often effective.
Labyrinthitis
Labyrinthitis is an inner ear infection that can affect your hearing and balance.
This infection causes the labyrinth, a delicate fluid-filled structure deep inside your ear, to become inflamed. Symptoms include dizziness and vertigo, nausea, tinnitus, and hearing loss. Although it can’t be diagnosed by a specific test, a specialist will be able to look at your medical history, assess your symptoms, and perform other tests to exclude the possibility of your symptoms being caused by a different illness or condition.
When treated promptly, your infection shouldn’t cause any permanent damage to your ear health. Nevertheless, there is a possibility of permanent loss of hearing or damage to the vestibular system. If symptoms persist, you will be asked to do vestibular rehabilitation exercises so your brain can adjust to the imbalance.
If you only experience the balance symptoms of labyrinthitis, without the hearing loss, this is known as vestibular neuronitis (although they still fall under the same diagnosis).
Neuronitis
Vestibular neuronitis (neuritis) is an infection of the vestibular nerve in the inner ear, causing it to become inflamed. Your balance is often affected and symptoms can range from mild dizziness to a severe spinning sensation. You might experience nausea, vomiting, difficulty concentrating, impaired vision, and might not be able to sit up or walk.
You'll probably experience a sudden onset of these symptoms, which is likely to interrupt your daily life.
Infections of the inner ear are often viral and are less likely to be caused by bacterial infections. The correct treatment for your case depends on the cause of your infection, so it’s important to see a specialist and get a correct diagnosis. Quick treatment is needed to avoid permanent damage.
Some people will continue to experience vertigo and dizziness. This can happen if the vestibular nerve does not recover, leading to chronic vestibular neuronitis. In this case, you might be given exercises to perform to tune your brain to the imbalance.
To learn more about hearing health, see our other blog articles.
The information in this guide has been written using the following reliable sources:
https://www.hearinglink.org/your-hearing/balance-disorders/common-balance-disorders/
https://patient.info/signs-symptoms/dizziness/
https://www.menieres.org.uk/information-and-support/symptoms-and-conditions/menieres-disease
https://www.healthyhearing.com/help/tinnitus/dizziness-and-hearing-loss
https://www.nhs.uk/conditions/vertigo/
https://www.asha.org/public/hearing/Dizziness-and-Vertigo/
