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  Inner ear problem may cause falls in elderly


By Amy Norton

NEW YORK, May 08 (Reuters Health) - Certain inner ear disorders are an often unrecognized cause of sudden falls in elderly people, according to California researchers.

Meniere's disease and related inner ear disturbances are at the root of recurrent falls and dizziness in some older people, yet many of these patients are misdiagnosed, according to Dr. Gail Ishiyama, a neurologist at the University of California, Los Angeles, School of Medicine. In a study of eight men and women who suffered unexplained falls, Ishiyama and her colleagues found that three had Meniere's disease and five had a condition known as delayed endolymphatic hydrops. She reported her team's results at the recent annual meeting of the American Academy of Neurology, held in San Diego.

Marked by an abnormal build-up of fluid in the inner ear, Meniere's disease causes recurrent bouts of dizziness, ringing in the ears and hearing loss. Delayed endolymphatic hydrops is related to Meniere's, but symptoms crop up after years of serious hearing loss.

In an interview with Reuters Health, Ishiyama said that hearing loss should be a "tip-off" to doctors that these inner ear syndromes are behind patients' falls. In her study, all of the patients had at least partial hearing loss and restricted eye movement related to the ear problem.

None, however, had been diagnosed with an inner ear disorder. One had been placed on antiseizure medication, while another had had a heart pacemaker implanted. Often, Ishiyama said, doctors suspect heart problems are behind falls in the elderly. However, people who fall due to heart problems usually lose consciousness, she added.

Among Ishiyama's patients, five received surgery to remove diseased inner ear tissue or had medication injected through the eardrum; 2 to 10 years later, none had suffered another sudden fall, according to Ishiyama. A sixth patient, she noted, recently elected to have the surgery when she nearly broke her hip in a fall.

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