Many on Dizzying Quest to Find the Right Balance

Months after a drug reaction ruined her sense of balance, Barbara Doyle took a trip to Europe. She had taught herself to walk again, but she still fell -- once in every country.

“I fell in Budapest, I fell in Prague and I fell in Vienna,” she said, remembering the 1999 trip.

Doyle, 72, and others like her with damaged inner ears are helping researchers study the body’s balance system and how vision, the touch of one’s feet on the ground and the ear’s fluid-filled inner labyrinth work together to determine which end is up.

Doyle’s contribution may one day help the estimated 6 million people in the United States dealing with chronic dizziness and balance disorders. As the nation’s population ages, their ranks are expected to swell because the motion-detecting cells of the inner ear can lose sensitivity with age.

Some researchers are focusing on the ancient Chinese practice of tai chi to help people feel more confident about their balance, whereas others are more futuristic: building prototypes of devices such as inner-ear implants and vibrating belts.

“Imagine a bunch of vibrating elements like in a pager or cellphone,” said Conrad Wall of the Massachusetts Ear and Eye Infirmary, who has a $2.5-million federal grant to develop a balance-enhancing vest or belt or -- as some female participants in the study suggested -- a balance bra.

“The motion sensor detects which way your body is leaning,” Wall said. “If you lean toward your right, the vibrations give you a cue that you have to straighten back up to vertical.”

At least several years away from the market, the device has tested well in shaky lab settings among people prone to falling. Whether it will help people walk with better balance is yet to be thoroughly studied, Wall said.

Balance problems have a wide range of causes, including migraines, aging, vitamin B-12 deficiency, small strokes and calcium debris that breaks off and floats in the inner ear where it sends jumbled signals to the brain.

Diagnosis is sometimes difficult. Doctors can’t tell why Heather Reed, 34, of St. Louis has had bouts of vertigo since last October. Her dizziness hits her hardest at the grocery store.

Experts such as Dr. Timothy Hain of Northwestern University Medical School call it “grocery store syndrome.”

Normally, people rely on their inner ears, their eyes and the feeling of their feet on the ground to keep their balance, Hain said, but people with inner ear problems tend to grow too dependent on what they see to stay upright. Grocery stores, with their floor-to-ceiling shapes and colors, are often the setting for vertigo attacks, he said.

“A third of my dizzy patients complain about this,” Hain said.

“When one of those senses goes haywire, like the inner ear, instead they use their other senses,” he said. “They stick with their eyes all the time and that messes them up.”

During one recent shopping trip, Reed experienced such extreme vertigo that she had to call her husband because she didn’t feel she could drive herself and her 7-year-old son safely home.

“It happens in a flash,” she said. “I feel dizzy and a little nauseated and slow, like I can’t move quickly anymore or I would fall down.”

Doctors have put her on anti-seizure medication, drugs for migraines and a low-salt diet -- all without results. Acupuncture helped for a while, she said, but her health insurance doesn’t cover it.

Hain, who consulted on Reed’s case, said research at the Rehabilitation Institute of Chicago by Emily Keshner may one day help people with grocery store syndrome, also called visual dependence.

In Keshner’s study, volunteers wear 3D glasses and watch disorienting moving images while a platform shifts beneath their feet. Cameras track the volunteers’ movements so researchers can see how they catch themselves, if they do, before they fall. A safety harness keeps them from hitting the ground.

“We haven’t lost anyone yet,” Keshner joked. Her project recruits volunteers like Doyle, the Chicago woman whose balance was damaged by the antibiotic gentamicin.

Inner ear damage is a known side effect of the drug, which Doyle said saved her life when she contracted an infection after back surgery.

Lynn Brown, a former flight attendant from Pell City, Ala., has formed an online support group for people hurt by gentamicin. Her Wobblers Anonymous group has 2,000 members, she said. “It’s very debilitating,” she said. “People do not understand.”

Brown said she never feels dizzy, but lives with the feeling that her vision is always jerking and swinging, a symptom called oscillopsia.

“The best way to describe it is if you took a video camera and held it tightly to your chest and walked around, then watched the video. Everything’s going to be bouncing up and down,” she said.

Like Doyle, she has participated in research studies, hoping to help find a treatment or a cure. “You will try anything to get better,” she said.