Patient Perspective

Military Resources

 | Coping & Support | Military Resources

Article Summary

While vestibular disorders can affect anyone, military personnel are exposed to unique risk factors for inner ear damage. Possible causes of vestibular disorders that may be prevalent in military settings include traumatic brain injury and neurotoxic vestibulopathy, particularly from certain prescribed antimalarials. The path to diagnosis for military personnel and veterans generally goes through your primary care physician (PCP). However, not all PCPs are trained to recognize vestibular disorders. You may find it helpful to educate yourself about the symptoms of a vestibular disorder so you can communicate this clearly with your PCP.

Vestibular Impairment & Military Service

While vestibular disorders can affect individuals of any age, background, or profession, military personnel are exposed to unique circumstances that can put them at risk for certain types of inner ear damage.

Symptoms of a Vestibular Disorder

The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders can result. Common symptoms include:

  • Vertigo and dizziness
  • Imbalance and spatial disorientation
  • Vision disturbance
  • Hearing changes
  • Cognitive and/or psychological changes
Learn More

Common Causes of Vestibular Dysfunction in Soldiers & Veterans

Possible causes of vestibular disorders that may be prevalent in military settings include traumatic brain injury and neurotoxic vestibulopathy, particularly from certain prescribed antimalarials. Symptoms of posttraumatic stress disorder (PTSD) may also confound the diagnosis of vestibular disorders.

TBI

The risk of blast exposure to deployed US military service members is significant. Traumatic brain injury (TBI) is a frequent consequence of blast exposure. Dizziness is a common clinical finding in people with blast-induced TBI.

Many US military service members who have been exposed to blasts in Iraq and Afghanistan complain of symptoms consistent with peripheral vestibular pathology such as vertigo, gaze instability, and motion intolerance.

Learn More

Antimalarials

Neurotoxic vestibulopathy is a common but under recognized outcome following use of the neurotoxic antimalarial drug, mefloquine (also known as Lariam). In 2013, the FDA cautioned that neurological effects from mefloquine, to include dizziness, loss of balance, or ringing in the ears, could be permanent. Other possible impacts include fatigue and cognitive problems. Mefloquine has been widely used by U.S. military personnel since its introduction in the 1980s, such as during operations in Somalia in the early 1990s, during Operations Iraqi Freedom (OIF) beginning in 2003 among personnel deployed to Iraq and Kuwait, and during Operation Enduring Freedom beginning in 2001 among personnel deployed in Afghanistan, and in related operations in Africa and Southeast Asia. As documentation of mefloquine prescribing was often poor, many military personnel will not have evidence of the drug in their medical record. A history of exposure to mefloquine should be assumed if the military service member reports taking a once-weekly tablet that is white slightly smaller than dime-sized, for prevention of malaria.

Learn More

PTSD & Vestibular Disorders

PTSD and vestibular disorders share many common symptoms, such as anxiety, headaches, difficulty concentrating, and social withdrawal. Soldiers diagnosed with PTSD may also have an underlying vestibular disorder.

Learn More

What to do if you suspect your vestibular system is damaged

The path to diagnosis for military personnel and veterans generally goes through your primary care physician (PCP). However, not all PCPs are trained to recognize vestibular disorders. You may find it helpful to educate yourself about the symptoms of a vestibular disorder so you can communicate this clearly with your PCP. Becoming an advocate for your own healthcare can greatly improve your chances of receiving an accurate diagnosis during the early stages of your condition.

  1. Educate yourself about vestibular symptoms and diagnosis.
  2. Download a dizziness and balance medical history questionnaire; fill it out and bring it with you to your PCP appointment.
  3. Ask your PCP for a referral to a medical facility that can perform comprehensive vestibular testing (see below for a list of military hospitals with vestibular testing capabilities). You may also request a referral to a civilian balance center (see VeDA's provider directory).
  4. Visit your local Veterans Service Office to engage the help of a Veteran Service Officer (VSO), who can represent you should you request disability status from the VA.

Resources for military personnel & veterans

PinLinkedIn

References

  1. Scherer, MR, Schubert MC. Traumatic brain injury and vestibular pathology as a comorbidity after blast exposure. Phsy Ther. 2009; 89:980-992.

  2. Defense Centers of Excellence Clinical Recommendation for Assessment and Management of Dizziness Associated with Mild TBI, September 2012.

Related Articles

Disability Resources

You never thought it would happen. You thought you would work until retirement or beyond, but then along came your vestibular disorder. Now, focusing on a computer screen is a challenge, someone has to drive you to work, walking is a safety hazard, and your concentration is not what it used to be. All of these symptoms can interfere with your ability to do the material duties of your occupation, and can make an attempt to get through a workday exhausting and frustrating as you struggle to complete tasks that used to be easy for you. You see your doctor and she tells you the time has come for you to stop working due to your disability. Now what? How will you live without your income?

More

Support Groups

Support groups provide a unique and critical service: acceptance. This forum allows individuals to ask questions and to learn in a non-judgmental and safe environment. Participants know that everyone attending the meeting understands and has compassion for the functional difficulties of getting through each day. As a result, less frustration and energy are spent on proving or defining limitations. More energy is available for appreciating the character and companionship offered by others, and recognizing personal self-worth.

More

Vestibular Injury

The vestibular system includes the inner ear balance organs and the parts of the brain that coordinate and process balance information. The balance organs contribute vital sensory information about motion, equilibrium, and spatial orientation. In

More