Damage to Inner Ear Often Misdiagnosed as Concussion

Concussions are serious business. Regardless of how “mild” they may be, immediate action must be taken. Unfortunately, the possibility of being misdiagnosed with a concussion following a head injury, when one has actually suffered damage to one’s inner ear, is very real. In both cases, the individual is likely to suffer from nausea, headache and dizziness. There is oftentimes a crucial difference, however, when it comes to length of recovery. Those with a sufficiently mild concussion may recover in only a couple of days, whereas those with even minor damage to the inner ear may suffer from debilitating vertigo, memory loss and intense headaches for several months.

Post-Concussion Syndrome vs Perilymph Fistula

Of course, post-concussion syndrome may itself last up to a year, which makes distinguishing the two syndromes all the more confusing. Although this particular form of inner ear injury (known as a perilymph fistula) may produce suffering that is more chronic. Unlike post-concussion syndrome, there is a definite, surgical medical treatment by which the inner ear can be successfully repaired. Indeed, despite similarity in symptoms, both problems have radically different biological causes. In the case of a perilymph fistula, there is a tear in the thin membranes separating the middle ear from the inner ear.

This tear causes small amounts of perilymph (a fluid in the inner ear) to leak out of the inner ear. The presence of this fluid in the inner ear is essential when it comes to maintaining balance and hearing. A concussion, on the other hand, is the result of traumatic damage to, and stretching of, nerve cells, resulting from head injury. While anywhere from 30-60 percent of perilymph fistulas result from head injuries, they may also result from acoustic trauma (such as being nearby a loud explosion), unequalized air pressure, such as that caused by diving or flying, or excessive exertion during childbirth or weightlifting. 

Methods of identifying inner ear damage

The difficulty is in distinguishing the one from the other, since the actual existence of the fistula must be simply inferred entirely on the basis of observed symptoms. Balance tests, known as “vestibular tests,” are one of the few methods of successfully distinguishing a perilymph fistula from a concussion. A doctor may also administer an electronystagmography exam, which tracks the involuntary eye movements of the subject. The inner ear tracks the movement and position of the head, with the result that the individual suffering from such an injury is unable to keep his eyes fixed on an object while moving his head. Hot or cold water may also be sprayed into the ear canal. This results in stimulation of the acoustic nerve, which contributes to one’s ability to hear and maintain balance. The involuntary eye movements which result from the rush of the water may help the doctor determine whether or not this balance system is functioning properly.