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It’s All In Your Head

October 05
09:38 2019

By: Dr. Abigail Joseph

The ear is such a wonderful organ. I am in absolute awe of it! You are probably reading this and wondering if the doc has lost her mind. Sure, you hear through them and you can wear earrings and well, that’s not a big deal. It’s a very good example to use when people say there is more than just what meets the eye. It plays a key role in balance and your orientation with regards to space and gravity. If we break down the ear – there is the outer ear, middle ear and the inner ear. Most people are aware of the outer ear. It is responsible for capturing sound and channeling it through the ear canal and bam we can hear!

Actually, it’s a little more complicated than that and without getting too deep into an explanation but just enough to intrigue you, I’d tell you – we superstitiously look at the ear and judge whether or not we will be rich by its size, but it is actually a funnel that guides sound. The brain cannot hear sound. When we speak or make noise, it sends off vibrations in the air. Each sound vibrates on its own frequency making it distinct from others. The ear capture these waves and direct the waves to the ear drum which vibrates and magnifies the waves. Why? Because these waves need to travel through liquid in the ear. Moving through air is easier than liquid. Ever tried running in water? Takes more effort, right? Well the tiny bones in the ear vibrate and sends ripples through the inner ear. Inside the inner ear are tiny hair like structures that bend due to the presence of these ripples.

Imagine looking at grass underwater. Picture how the waves make them flow back and forth? Well the hair like structures in the ear bend in similar manner. These structures sense the ripples and are interpreted and translated by receptors and converted to electrical impulses which travels to the brain. The brain then interprets this sound and identifies it. AMAZING how fast it all occurs.That must be some super speed.

But the ear is not only responsible for capturing sound and delivering it to the brain. It is also our center for balance control. Within the inner ear you will find three semicircular canals filled with fluid. They are situated at right angles from each other (anterior, posterior and horizontal) and their purpose is to help us know how we are oriented in space with regards to our head position and gravity. When we move our head in a specific direction the fluid in the canals moves, and the tiny hair like structures I mentioned earlier sway and send impulses to the brain telling the direction of our head with respect to our position with gravity. Basically it helps us to know which way is up and which way is down and how we are moving on a particular plane. Sounds simple and if everything is functioning properly it is indeed very simple.

As children, we used to enjoy hanging upside down, going high up on the swing, and even spinning each other around. At times when we came to a pause we giggled at the temporary giddiness. This temporary dizziness if due to the action of the fluids in the ear and gravity. It goes away when your body comes to a stop because your vestibular system is functioning properly. But there are times when you get up out of bed or open your eyes and barely move and you feel your entire world start spinning. If you try to remain still it goes away but if you move you are completely at a loss. It feels like you are on a roller coaster or spinning really fast even though you know you are in a stationary place. What is happening?!

Vertigo is the sense of the world spinning or rotating even though you are perfectly still. It may be a funny sight to see someone crawling on the ground or gripping the bathroom door with fear due to their world spinning but I assure you it is no laughing matter. No one wants to feel out of control, no one wants to be on a roller coaster all day long. But why do we feel this way. Vertigo has two causes: peripheral and central causes. Peripheral causes refer to the disorders of the ear while central refers to disorders involving the brain. The most common type of vertigo is BPPV (Benign paroxysmal positional vertigo) where small crystals commonly referred to as “ear rocks” end up floating around in the ear fluid as debris. When we move, these crystals travel and get trapped in the semicircular canal that are filled with fluid. They knock around in there and they make contact with the hair-like structures that in turn sends signals to the brain telling the brain that we are moving in that direction when in fact we are stationary.

This confuses the brain, especially if rocks are in more than one of these loops. Remember these loops are designed at angles to help us understand movement and where we are with regards to gravity, and if these hairs are making contract in different places telling the brain we are moving in these directions, it gives a false sense of movement. BPPV is a self-limiting symptom and resolves in about 6 weeks, but let’s be real, no one wants to experience vertigo for more than a day. Other causes of vertigo are due to infections of the ear that affects the vestibular system and central causes include tumors.

No matter what the cause may be- it is all in your head (literally). If you are experiencing dizziness frequently it is important to get checked by a physician. Not because the symptom in itself is life threatening but because the feeling of imbalance is a threat. The risk of fall is a concern for all ages but even more so in the elderly. Seek help today.

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