Connection between blocked ears and vertigo?

Ears, nose and throat
1

First post in this forum. Has anyone else noticed a correlation between impacted wax in the ears and attacks of vertigo? I'm a 72-year-old female who has Sjogren's syndrome (an autoimmune condition).

I've been having vertigo for the past four weeks. It was very bad at first - one particular day I actually couldn't stand up all day without falling over and was reduced to crawling around on all fours. I vomited a lot due to the constant spinning, and was unable to keep even water down. It's calmed down a bit now, but I still can't walk straight, feel vaguely seasick all the time and have to be very careful about head movements.

This is by no means the first time. I've had sporadic attacks of vertigo all my life, even in childhood. The last serious, prolonged attack was 30 years ago, when I was diagnosed with benign paroxysmal positional vertigo (BPPV). My hearing was found to be normal at that time and hasn't deteriorated noticeably since.

I've always had a tendency to form hard plugs of wax in my ears too, especially the left one (possibly because I mainly sleep on my left side). Now, I've long since noticed I seem to get acute attacks of vertigo at times when I have a plug of wax in that ear. However, the ENT specialist I saw 30 years ago, and who diagnosed BPPV, flew into a rage when I dared to suggest the plug of wax I had in my left ear at that time could be connected in any way. (He was a very disagreeable old gent who appeared to be well past retiring age.)

Just back from a visit to an ENT specialist at the hospital this morning, who once again found a plug of wax in my ear. I knew it was there, even though it wasn't affecting my hearing this time. He was quite young, but also got very huffy when I politely asked whether this might be responsible for my current acute attack of vertigo. He said I was "talking rubbish". What is it with ENT doctors, btw? They all seem to be vile-tempered. I even saw a homeopathic ENT specialist once, and he was even worse!

I'm now waiting to see whether the vertigo wears off over the next few days. I know I have to be patient, as this morning's prodding and high-speed irrigation jet (which took nearly 5 minutes to get the plug out) probably haven't helped.

I also had a hearing test this morning, which found normal range in my right ear and slight loss in the left (affected) ear. The technician said she thought this was due to the test being performed immediately after the irrigation, which would have left some residual water in my ear. (I asked the doc about this when I briefly saw him again afterwards, and he said that was "rubbish" too.) He did tell me, however, that the hearing loss was no more than he would expect at my age.

Can anyone offer any insights?

2

Well Lily first off I have to say ENT's have in my experience mostly been like this. Dont seem to,like us asking questions! I would have thought as you have Sjorgens the consultants in that field would be able your answer your questions better than ENT's about dizziness symptoms.  However i can say that wax wont be the cause as wax is on the outer side of the ear drum.  Most things that cause dizziness come from the Vestibular system, as per your diagnosis of BPPV,so i'd say it's that again.

you might  be interested to,look at the website of  Veda (vestibular disorders association) they have a wealth of information on all things vertigo,dizzy stuff etc. And all conditions that cause it!

i've learned in my 6 nearly 7 yers of this you have to do your own research as relying on Consultants doesnt always get you all the answers!

3

Lily, HUGS to you!! This vertigo is terrible and it's not clear what caused the onset (this time, last time...future times?). Sometimes not knowing is almost as bad as the attacks.

What one of your impatient specialists should have explained to you is that your balance is part of the vestibular system. It's related to the ear, but the very inner ear where it connects to the brain. That delicate mechanism does have a hearing part and a balance part.  The ear canal, is part of the ear's exterior and the two aren't as connected as they seem. Ear wax is part sweat and part fat, essentially, and tends to clean itself out when you shower. Sometimes, the system needs a boost, so see what your doctors recommend to keep yours from building up with secretions (wax). 

Between the ear canal and the tiny bones and "ear drum" is a membrane. It's true that when that's punctured your balance can be off. If someone tries to clean his/her own ears, let's just say, and accidentally damages that membrane with a QTip, then it's likely for an attack to occur. But, it would have other signs too - like PAIN, some hearing loss, rining/noise, etc.  And, the doc would have seen the damage while examining your ear.  That's the only connection I can think of...and that doesn't seem to be the case you're describing.

In my case, decongestants help when my head is stuffy and that's leading to my dizziness (also diagnosed as BPPV). The decongestants make me dizzy and sleepless, but it's somehow better and that wears off faster than the vertigo. When my low B12 was found, my vertigo was worsening and the shots helped me quite a bit! So, see about other possible triggers - there may be something you can do to prevent this from happening again. Or from happening so severely.

I hope you're better every day! 

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If I may, my suggestion in your case is to see a neurologist.  I am concerned about your inability to walk during your sudden onset of vertigo.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

 

5

Thank you for your kind words, Aveline.

I was actually a nurse for 10 years, but that was back when dinosaurs walked the earth! My speciality was neuro, but I have a general understanding of how the balance system works. Your post made me realise, though, how delinquent both the ENT specialists were in their failure to explain things. After all, I never told either of them I had any kind of medical knowledge.

I totally agree that the idea of a build-up of wax causing vertigo makes no sense. This is based on 50 years of observation, which is why I find it mystifying. In fairness though, a couple of reputable medical sites do concede there might be a connection - notably NHS Choices and Medical News Today. In the run-up to the severe attack 30 years ago I'd been wearing wax earplugs every night for months, as my upstairs neighbour's toddler had been going through a very distressing period of screaming all night every night. And it's just occurred to me that four months ago I took a holiday where I went on excursions every day where the guides used the radio system of giving their commentaries. This involved wearing earpieces - very hard and of poor quality in this case - for long periods. I've certainly never used Q-tips in my ears, btw. I still remember my first ENT lecture circa 1965, when the doctor told us: "Never put anything smaller than the tip of your little finger in your ear!" But they're very good for cleaning the inaccessible bits of the cooker hood.

I hope I'll get better every day too, and I've a feeling I will. While following up on potentially sinister conditions, my general health policy has always been that most things clear up if you wait long enough!

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Hi Gillian,

You're quite right. I should raise this question over on the Sjogren's board, where I usually hang out. I only saw a rheumatologist once, when the condition was first diagnosed 12 years ago - 10 years after the first symptoms, which is about par for the course. I decided not to continue down that route as I didn't intend to take DMARDs or immunosuppressants, preferring to manage my symptoms with lifestyle measures. The only prescription medications I take are L-thyroxine for an underactive thyroid and, more recently, a steroid inhaler for late-onset asthma (both consequences of SS, of course). I'm very lucky in having the support of a fantastic GP who really understands autoimmune diseases - a rare bird indeed!

He did, however, raise an interesting point when I saw him a couple of weeks ago. He thinks this latest attack might be viral vestibular neuritis. He has a theory that the current adenovirus that's doing the rounds of northern Europe is sidestepping the respiratory system in some patients and attacking elsewhere.

Totally agree about having to do your own research. I doubt whether I'd ever have got a diagnosis of Sjogren's if I hadn't done this. Not that it would have made much difference, I suppose, as I don't take any of the specific drugs that can be prescribed for it!

Thanks for that Veda tip. I hadn't heard of them before and will definitely check out their site. I hope you're managing to keep your own vertigo under control.

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Yes, that had occurred to me too! The neurologist will be my next port of call if this attack doesn't wear off after a few more weeks. Still, having had vertigo for most of my life, with several acute attacks over the past 50 years, I suspect it's unlikely to be down to any serious (or at least treatable) neurological cause. Thank you for your advice.

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i know this is the prob with immune  suppressants. I've had plenty of steroids in my time. Developed Crohn's in midtwenties. (68 now). Plus NSAIDs. I try to manage my vertigo symptoms naturally as much as i can with  homeopathy (I know medical,profession dont agree with it!), supplements to,keep,me going as have big enrgy probs. 

The viral,thing is a good possibiltiy.am sure thats whay brought mine on as it was,literally overnight!

do t know if,you've heard of LDN. low Dose Naltrexone?  People who,have Sjorgens prefer it as it's lot less than regular steroids, side effects etc and apparently have good results. NHS wont prescribe it, although my gastroenterologist at Barts where I used to,go, admitted they use it but for my probs. Apparently they use it for drug addicts! God knows why.  But  you can get it and take legally. The LDN has a website,you,may want to check it,out

9

That's interesting. I'm glad you raised it. I'd never heard of naltrexone being used in that context. I only know of it as an opioid antagonist used mainly in conjunction with the Sinclair method of reducing alcohol dependency. I volunteer in a mental health centre and we get a lot of training to keep us up to speed in new techniques etc.

It's the opioid antagonistic action that works in drug addiction (but only to opioids obviously) by blocking the body's usual reaction to the drugs. But it doesn't do anything to get addicts off the drugs long-term.

Its use in the Sinclair method is more interesting. When taken by alcoholics immediately before drinking it blocks release of the body's natural opioid-type chemicals, which are what produce the pleasurable effect of drinking. The theory is that they gradually find they lose the craving for alcohol over time as it no longer produces the same intense degree of pleasure, as long as they continue taking naltrexone while drinking. It seems to work well for some people but takes a lot of discipline and a real desire to reduce drinking.

I'd never heard of its low-dose use, so had to google that. I found a very interesting, though highly technical, report on the NCBI site. It seems they're not sure yet how it works for autoimmune diseases as the site explores two entirely different mechanisms! Sounds very promising, however it works. I'll raise that one on the Sjogren's site.

Oh, and I take homeopathy too - mainly for joint and tendon problems, also related to Sjogren's. I've tried it for all sorts of things over the past 40 years, but I find it only works for autoimmune conditions in me. Which does beg the question of whether the effect is just down to placebo, of course. Personally I don't give a flying you-know-what! My view is that if it works by placebo that's still OK with me. I mentioned this to my very tolerant, open-minded GP at my last consultation. He smiled sagely and said: "Ah - a pragmatist!"

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Hi, well thats good to hear. And the fact you know a lot about medical things, drugs etc too helps eh?  I was interested too to read that about how Naltrexone is actually used for drug addicts, well alcoholics as i couldnt work out the connection to say Sjorgens. They even recommend it for Gastro probs like me!  But because i dont know anyone who's tried it, i've not followed through.  And to be honest, my Vertigo symptoms are my priority.

interesting too, I just received an email from my brother in NZ and he has just watched a programme there about an English lady, ex school teacher, who's,had this problem for 60 years!  She had a viral infection in her vestibular area as a child (I've always been convinced this is what brought mine on).  In the programme where she went to the Leicester Balance Centre,which i've heard is very good, they explain that most people recover as the brain retrains itself back to normal, but in some people it doesnt.  I will have to re read the email for the correct diagnosis given to her as it includes something re the visual side. ,i know for a fact my eyes have 'kicked in' to help with balance, to the point of exhaustion, but the exercises they give via vestibular therapy never worked for me no matter how many times I repeated them and other people have had the same experience.  Maybe works better for younger people?

re the Homeopathy,i know what they say about placebo, but i guess that could also be said for Paracetomol eh? I always counter that with, well my dog,doesnt like me giving him pills, but I use it,on him and he responds really well, so the Placebo idea flies out the window. I,love to see their faces when i say that,haha!

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Vestibulopathy with a visual Preferance, was the diagnosis.

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I once saw a BBC TV programme in which a farmer said he used homeopathy to treat his cows. He said it worked, even for mastitis!

I don't like paracetamol personally. It's far more hepatotoxic than most people realise and in any case it never works on me. The only pain relief I take is ibuprofen for an occasional headach.

Interesting to hear the NZ lady's story. I too had vertigo all my life. I have clear memories of waking screaming as a small child, as the room was spinning and I thought I could feel someone moving my bed. Maybe my lifelong vertigo was down to a virus too...

I also suffered severe car sickness as a child and a young woman, though fortunately it wore off in my late 20s. I can remember being unable to stand because of vertigo when I got out of the car. I still have to be careful not to try reading in a car or bus even now. And I'd never get in a car where someone was smoking.

Unfortunately, the sea sickness never wore off, though I've only ever suffered it when crossing the English Channel, which I did regularly in the days before the Eurotunnel opened. There seems to be something special about the swell in that stretch of water - I believe it's called "corkscrewing". I once crossed the Pearl River estuary from Hong Kong to Macau at night in a small ferry boat at the start of a typhoon. I was absolutely fine, though everyone else was throwing up around me and we were all dodging anything that wasn't screwed down. But the Channel... bleugh!

I can connect with the visual thing too. On my early Channel crossings, which always took place in daylight, people used to tell me to go below, where I couldn't see the horizon, and try to lie down. But I soon learned that was the worst possible advice for me. My preferred tactic was to stand up on deck, regardless of the weather, and fix the horizon with my eyes. That way I was always OK. I suspect I was unconsciously moving my head to keep the fluid in my semi-circular canals aligned with the horizon - a bit like a human spirit level. The only thing you have to remember though is not to look up at the mast or funnels moving against the sky!

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Yep. Can see that with the farmer! A natural therapist i see said that animals are so tuned into these things and respond well.  Funny how we are withnpain killers, Ibu does nothing for me, but Para plus works on headaches  good. I used to take .vegananin back in the day for,bad headaches then. Now i use a cold,gel'pack which really helps aswell Cant take anything strong now. Turn down all the meds consults what to,put me on! They just

make my head worse!  I get shocking stiff sore neck and shoulders and on top,of arthritic stuff that came after Crohn's I have Naproxen if I need it, but try to stay off as much as i can and only ise when i'm 'bad'. gastro not keen on me having it, but then Rheumy say ok!!i hear you in the travel sickness. I cant look down on a bus or car (Trains are ok) and not good in back seat of cars either. I was same as a child like,you then. It wore off after puberty and came back at menopause!! I also get nauseous now since the vertigo started with looking at one spot,for too,long. So cant read books, even newspapers have to look away. And am sure boats wld be the same. As you say different waters. IRish channel"s bad, although i wasnt as bad as my friend who spent the whole crossing in the loo!  The corkscrewing fits the description perfectly.  agree about not going down below on boats,,i learned that one too. As Humphrey Bogart told Lauren Bacall, keep,eyes on the horizon!,  you reminded me of my Dad's old jalopy,,a Ford when i was a kid, never got travel sick in that, bumped along like crazy, but my aunts fancy car,was paper bag time!!