This month we discuss a condition called Autoimmune Inner Ear Disease (AIED). Our immune system constantly monitors our bodies for invasion by foreign germs and will rigorously attack them as a defense mechanism using antibodies or immune cells. Unfortunately, sometimes our immune system mistakenly identifies structures in our body as foreign and will launch such an attack. One such area that can be susceptible to such an attack is our inner ear which houses our vestibular system and the cochlea (hearing center) causing damage and a decrease in function in one or both. Our vestibular system is responsible for transmitting information regarding head, eye, and body movements to our brain. Our brain, in turn, uses this information to help us maintain our balance and to keep the environment stable visually when moving our head and eyes.

Damage due to AIED can cause:

• Disruption of Information from the Inner Ear to the Brain
• Dizziness (wooziness, light headedness)
• Vertigo
• Balance Deficits
• Sudden Hearing Loss in one ear progressing to the other ear
• Tinnitus (ringing, roaring, hissing)
• Ear Fullness
• Autoimmune Disorders Occur more frequently in women than in men, less frequent in children and the elderly

Autoimmune disorders that can affect the inner ear include:

• Cogan’s syndrome
• Relapsing polychondritis
• Polyarteritis Nodosa
• Wegener’s Granulomatosis
• Systemic Lupus Erythematosus
• Ulcerative Colitis
• Sjogren’s Syndrome
• Rheumatoid Arthritis

Treatment: Drugs that reduce immune function (immuno-suppression), and they have body-wide effects. They include steroids, chemotherapy agents, anti-transplant rejection drugs, and the newer anti-tumor, necrosis-factor drugs.

Treatment for Dizziness and Balance problems because of AIED: Damage to your inner ear because of AIED can lead to dizziness, vertigo, and balance deficits. The essential first step in rehabilitation of these symptoms is getting to a qualified clinician. Choosing a physical therapy practice at random, or one referred by a physician, does not mean you are getting to the right place. Symptoms of dizziness, vertigo, and balance deficits are neurologic problems and need to be addressed as such. Treatment in an orthopedic/sports setting for these symptoms yield little, if any results, because the focus is on strengthening and not addressing the neurological deficits cause by AIED. Treatment needs to be on addressing deficits in the somatosensory, visual, and vestibular systems (the three balance systems in our bodies), and enhancing their function and coordinated input to our brain. The Center for Balance and Dizziness is the only practice in Cincinnati that exclusively treats individuals suffering from dizziness, vertigo, and balance deficits.