Dizziness: A Common Disorder

Don Colburn's article on dizziness {Cover Story, Nov. 13} really hit home. Since May 19, I have been experiencing vertigo and the vomiting associated with it. My doctors initially believed this was caused by a virus and would subside in six to eight weeks. When the dizziness persisted, I underwent a series of tests, including a magnetic resonance imaging scan to rule out a brain tumor.

Additional tests by an ear specialist indicated the problem could be a fistula in the middle ear, and I am scheduled for exploratory ear surgery. Although there is no guarantee that this will find the answer, at least there is some hope.

Though the doctors have been encouraging and helpful, I wish there were someone around to tell me how to deal with dizziness on an everyday basis. With responsibilities at work and home, it is hard to keep going when I feel like I am on a boat that is constantly rocking 24 hours a day, seven days a week.

My goals now are to be able to put my head down on a pillow to sleep, tilt my head back so the hairdresser can shampoo my hair before cutting it, be able to go to the dentist and have the chair in a reclining position, read a book without having to stop every few pages, drive a car and, most of all, regain my independence. Jackie Conover College Park

Particularly frustrating for doctors and patients alike are the difficulties in diagnosing the cause of dizziness, which the article described in detail. If all the neurological tests are negative, a victim of recurrent attacks of dizziness should consult the family dentist before giving up in despair.

In my case, a routine teeth-cleaning revealed evidence of bruxism -- grinding of teeth, especially at night. My dentist confirmed that this clenching of the jaws could cause dizziness by affecting the inner ear. I have used a "bite plate" at night for several years and have not experienced an incident of dizziness since. Sam Kaplan Charlottesville

Dizziness is by far the most challenging problem facing ear-nose-throat specialists. The diagnostic possibilities are many and are often elusive. In your broad overview of this complex topic, the diagnosis of an inner ear fluid leak, known as a perilymphatic fistula, was mentioned as a potential treatable cause of dizziness.

A survey conducted of more than 7,000 otolaryngologists put the incidence of this condition at 10 or 12 patients per 100,000 people who visit ear-nose-throat specialists each year, yet there is no agreed-upon diagnostic test for this disorder. The fluid volumes that may leak are minuscule and difficult to detect.

The National Institute on Deafness and Communicative Disorders is offering $7.5 million in grant support to develop better testing for this disorder. Michael S. Morris, MD Georgetown University Medical Center Washington

I lost my hearing at the age of 2 1/2 from influenza meningitis. Also, my inner-balance mechanism was destroyed. When I attempted to walk again after recovering from my illness, I fell down. I had to learn to walk again, using my eyes to help compensate for the lack of equilibrium. Even now, I have to be careful not to turn my head backward rapidly, or I'll lose my balance.

Walking in the dark or in the snow is also hard unless I can focus my eyes on something in the distance. Perhaps people with dizziness related to problems with their inner ear can learn to use their eyes to balance properly. Rebecca Warthen-Dunn Herndon

More on Sensory Integration Therapy

Bravo for the accurate and balanced article on sensory integration. This is a branch of occupational therapy practice little known to the public and little understood by some in the medical community. The article {Children's Health, Nov. 6} addressed a crucial point regarding the reluctance of most pediatricians to refer children of this type for evaluation and treatment.

However, in the 1990s, it is high time for physicians to recognize that allied medical professionals -- including occupational, physical and speech-language therapists -- are studying the neurosciences and offering neurologially based treatment approaches to help children with developmental problems. Lynn A. Balzer-Martin, PhD Washington

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