Beyond Dizziness: Other symptoms of vestibular disease

Ringing in the ears, called tinnitus,  is a sign of inner ear disease.  It is normal to occasionally feel a sudden stuffiness in one ear followed by ringing that gets louder and then subsides over several seconds.  When the feeling persists for several minutes or more, it can indicate an ear problem.   The sounds heard in a diseased ear are described most commonly as a high-pitched ringing sound, but you might hear a buzzing sound, humming, or a fuzzy sound like you hear in-between stations on the radio.  Sometimes there can be a low-pitched ringing or roaring quality, like a vacuum cleaner.  There can also be clicking or clanking noises in a diseased ear. 

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Why does vertigo make me sick?

Nausea and vomiting commonly accompany vertigo.  People vary in how sensitive they are to motion.  Some vomit with even mild dizziness, and others can experience violent vertigo with only mild nausea.  If you can see the environment spinning, and it continues for more than a few minutes, nausea will usually begin to build.   Vomiting can be set off by several different bodily systems (food poisoning in the stomach and intestines, for example) and it is controlled by the brain with a very complex set of subsystems. 

The vestibular system is interconnected with the reticular formation, part of the brainstem that coordinates and controls key centers for consciousness.  This formation includes the reticular activating system, a network in the brain that helps in arousal and awakening.  It is important that a person awaken when the head is suddenly moved, because it can indicate an impending fall.  When you abruptly jerk your head upright after starting to nod off, or when someone shakes you to help wake you up, you are using this system.  

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The problem of falling

Falling  can occur due to vestibular disease, but also happens in normal people.  Humans stand on two feet, which is much less stable than the four-footed mobility of most animals.  To master this, we had to develop a tight system of reflexes and feedback to our balance system.   There are three critical areas:

1) The vestibular system of the inner ears and brain.  This keeps your brain informed about any head movements that occur and sends out appropriate reflexes to the eyes and body.

2) Vision, including 3-D vision and visual tracking.  Vision overlaps with the inner ear in keeping track of head movements. It also gives feedback if vision is blurred by movement that helps fine-tune the reflexes.

3) Sensation, strength and mobility in the legs and feet.  The arms, hands and neck are also part of this system.  These body parts need to be able to respond smoothly and quickly to the reflex information being sent to the balance system and give feedback about the ground or environment that is conveyed by touch and position sensors.

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