Can a child experience loss of balance with an ear infection, specifically otitis media?

From the Guidelines

Yes, a child can experience loss of balance with an ear infection, particularly with otitis media, as the infection can affect the vestibular system, which controls balance. This occurs because the inflammation and fluid buildup behind the eardrum can disrupt the normal functioning of the inner ear structures responsible for maintaining equilibrium. Children with otitis media may appear unsteady, clumsy, or dizzy, and might have trouble walking straight or may fall more frequently than usual. These balance issues typically resolve as the ear infection clears.

Key Points to Consider

• The vestibular system, which is responsible for balance, can be affected by the infection in the middle ear, leading to balance problems in children with otitis media 1.
• Treatment for the underlying ear infection usually involves antibiotics such as amoxicillin (40-90 mg/kg/day divided twice daily for 5-10 days) or amoxicillin-clavulanate if resistant bacteria are suspected, as well as pain relievers like acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (10 mg/kg every 6-8 hours) to manage discomfort 1.
• If balance problems are severe or persist after the infection clears, further evaluation by an otolaryngologist may be necessary to rule out complications or other conditions affecting the inner ear 1.

Management and Treatment

• Watchful waiting for 3 months from the date of effusion onset (if known), or from the date of diagnosis (if onset is unknown), is recommended for children with OME who are not at risk for speech, language, or learning problems 1.
• Hearing testing should be conducted when OME persists for 3 months or longer, or at any time that language delay, learning problems, or a significant hearing loss is suspected in a child with OME 1.
• Tympanostomy tube insertion is the preferred initial procedure when a child becomes a surgical candidate, and adenoidectomy should not be performed unless a distinct indication exists (nasal obstruction, chronic adenoiditis) 1.

From the Research

Loss of Balance with Ear Infection

• A child with an ear infection, specifically otitis media, may experience symptoms such as fever, otalgia, headache, irritability, cough, rhinitis, listlessness, anorexia, vomiting, diarrhea, and pulling at the ears 2, 3, 4.
• However, loss of balance is not a commonly reported symptom of otitis media in the provided studies.
• Some studies mention complications of acute otitis media, such as labyrinthitis, which can cause balance problems 5.
• Labyrinthitis is an inner ear infection that can cause symptoms such as vertigo, dizziness, and loss of balance 5.
• It is possible that a child with otitis media could experience loss of balance if the infection spreads to the inner ear or affects the vestibular system, but this is not a direct symptom of otitis media itself.

Related Symptoms and Complications

• Otitis media can cause a range of symptoms, including ear pain, fever, and hearing loss 2, 3, 4.
• In some cases, otitis media can lead to complications such as acute mastoiditis, facial nerve paresis, and sinus vein thrombosis 5.
• Children with otitis media may also experience hearing loss or language delays, which can be assessed through hearing and language testing 2, 4.

Diagnosis and Treatment

• The diagnosis of otitis media is based on symptoms such as otalgia and fever, middle ear inflammation, and middle ear effusion 2, 3, 4.
• Treatment for otitis media typically involves antibiotics, such as amoxicillin, and symptomatic relief of pain and fever 2, 3, 4, 6.
• In some cases, watchful waiting may be appropriate for children with uncomplicated unilateral otitis media 6.