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Sculpture by Auguste Rodin- Die Buerger von Calais

A sudden problem with one’s inner ear system can cause symptoms such as vertigo, dizziness, nausea, vomiting, and difficulty walking.  We have always understood that when both ears are normal, the brain gets the same amount of information from each ear, and therefore does not have these symptoms.  However, when a person suddenly gets an inner ear problem in one ear only, the information sent to the brain from each ear is no longer the same amount from each side.  This imbalance of information results in the symptoms of dizziness, nausea, vertigo, and difficulty walking.   Putting myself in the other person’s shoes, it seemed natural to me that anyone with these symptoms could feel anxious, emotional, fearful, and worried.  But why is it that some people experience more anxiety than others?

Last November while attending the Politzer Society Meeting in Antalya, Turkey, I was fortunate to run into a colleague named Dr. P. Ashley Wackym.  He is an otologist, (a surgeon who specializes in inner ear problems), who practices at the Ear and Skull Base Center in Portland, Oregon.  I asked Dr. Wackym if he is involved with any new and exciting research on inner ear problems.  He shared with me that research from his center is now showing that when a person has a sudden or fluctuating inner ear problem in one ear only, that this asymmetry of information that is reaching the brain can cause issues with another part of the brain called the hippocampus. The 3 top things that this trouble with the hippocampus causes is as follows:  cognitive dysfunction, spatial disorientation, and anxiety.   I have seen this with my own patients who complain of difficulty concentrating, feeling clumsy when moving through space, and feeling emotional, tearful and anxious.  Dr. Wackym states that the anxiety occurs with more severe inner ear vestibular asymmetries, and that the anxiety felt is extreme.  Patients may describe a feeling of impending doom, or that something really bad is going to happen.  The good news is that when the brain recovers, and adjusts to the change of information received from the two ears, the hippocampus also returns to normal function, and the anxiety, difficulty concentrating, and spatial disorientation improve; however, this can take some time.  Dr. Wackym says that once his patients understand why they are having these symptoms and that things will get better as they recover, they feel greatly relieved.  It decreases their concern, and lets them know that there is a medical reason for their feelings, that they aren’t crazy, and that things will get better.  

Thanks for update, Dr. Wackym!