Gentamicin Induced Balance Disorders

Three crucial components work together to keep us balanced when we are sitting, standing, or walking. Remove any one of the three and we lose our sense of balance.

Staying Balanced

Your sense of balance is controlled by:

• Vision - being able to see what is up and what is down
• Proprioception - the feeling of pressure on the bottoms of your feet, or feeling how far your joints and muscles are flexed, all of which help provide a sense of your body’s position spatially
• Vestibular input - signals to the brain from the inner ear, or vestibular system

Gentamicin can kill the “hair cells” of the inner ear that sense motion, sense gravity, and provide input to the nerves connecting the inner ear to the brain. Without these hair cells, the body has no internal “gyroscope” to keep the body in balance. If you have been the victim of gentamicin poisoning, your body’s vestibular system has been damaged and you must rely on vision and proprioception, (feeling the ground with the soles of your feet, or feeling a chair underneath you to know which is up and down), to keep you balanced upright.

Depending upon the degree of vestibular loss, a gentamicin induced balance disorder usually requires a person to use a staff or cane to help them ambulate. A person usually doesn't walk in a straight line. Rough surfaces are harder to navigate than smooth surfaces. Any distraction such as wind, loud noise, crowds, or moving objects can make it even more difficult to ambulate.

Because balance is now completely dependent upon eyesight and proprioception, any small loss of these senses is amplified. Diabetes can affect both eyesight and the sensation from the feet. Unfortunately, diabetes can greatly compound the impact of ototoxicity, as can normal aging.

There is no cure for gentamicin-induced balance disorders, but treatment by a medical professional who specializes in vestibular rehabilitation or balance disorders can help you learn to compensate for the problem.