By: Himja Upadhyay, Registered Physiotherapist
In our last blog, we discussed benign paroxysmal positional vertigo and vestibular rehabilitation therapy.
In this post, we will delve further into the vestibular system and vestibular system disorders.
The Vestibular System
The vestibular system is comprised of three semicircular canals and two otolith organs (saccule and utricle). These five sensory organs provide the brain with information about head position and movements. It is present on each side.
It is also termed as “inner ear”, as it is connected to the hearing mechanism (cochlea).
Types of Vestibular Disorders
Diseases of the vestibular system can take different forms.
Here are some of the common disorders:
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV occurs as a result of tiny crystals of calcium carbonate – a normal part of the inner ear – which detach from the utricle and get collected in one of the semicircular canals.
When the head moves, the crystals can shift. This leads to the transmission of false signals to the brain, producing vertigo (spinning) and abnormal eye movements with the change in head position.
BPPV is benign, meaning that it is not life-threatening or generally progressive.
Age-related Dizziness and Imbalance
Most people are familiar with the problems associated with the aging of senses such as vision and hearing. However, the vestibular system is another sensory system that can also begin to function poorly with age, leading to a diminished quality of life.
The gradual, age-related loss of vestibular nerve endings can result in severe balance problems without any associated dizziness. This type of slow loss of vestibular function may be first noticed as difficulty walking or standing, especially in the dark while on soft or uneven surfaces (such as thick carpet or a forest path).
Bilateral Vestibular Hypofunction
Reduction or loss of vestibular function bilaterally results in reduced balance stability, especially when walking in the dark or on uneven surfaces, and decreases the person’s ability to see clearly during head movements.
Bilateral vestibular hypofunction and loss can occur as secondary to a number of different problems.
Labyrinthitis and Vestibular Neuritis
Labyrinthitis and vestibular neuritis are disorders resulting from an infection that inflames the inner ear or nerve which connects the inner ear to the brain. They can cause acute vertigo and unilateral vestibulopathy.
Symptoms of neuritis can be mild or severe, ranging from subtle dizziness to a violent spinning sensation (vertigo).
Symptoms can also include:
- Difficulty with vision
- Impaired concentration
Sometimes the symptoms can be so severe that they affect the ability to stand up or walk.
Labyrinthitis may produce the same symptoms, along with tinnitus (ringing or noises in the ear) and/or hearing loss.
Meniere’s Disease and Endolymphatic Hydrops
Meniere’s disease and endolymphatic hydrops are due to the malabsorption of fluid causing fluctuations in pressure in the inner ear fluid.
These two diseases differ in that the pathological mechanism causing Meniere’s is unknown, whereas endolymphatic hydrops occurs due to a head blow, infection, degeneration of the inner ear, or tumour. Meniere’s disease or hydrops usually involves an initial sensation of ear fullness, tinnitus, and fluctuating hearing loss, followed by vertigo, imbalance, nausea, and vomiting.
Acoustic neuroma (also called a vestibular schwannoma) is a serious, but non-malignant, tumor that develops on the sheath of inner ear’s nerve (vestibulo-cochlear). This nerve transmits both balance and sound information to brain (also referred to as the “acoustic nerve”, hence the name).
As an acoustic neuroma grows, it compresses the nerve, usually causing hearing loss, tinnitus, and dizziness or loss of balance.
Migraine-Associated Vertigo (MAV)
Migraine, a disorder usually associated with headache, is extremely common and can cause several vestibular syndromes.
Studies suggest that about 25% of migraineurs experience dizziness or vertigo during attacks. Migraine-associated vertigo (MAV) can occur with or without pain.
The vertebral and basilar arteries carry blood to the inner ear labyrinth, the vestibulo-cochlear nerve, and the brain. When blood flow through these vessels is restricted for any reason, it is called vertebrobasilar insufficiency.
This is a common cause of vertigo in the elderly. The vertigo occurs suddenly without warning, usually lasts for several minutes, and can also be accompanied by nausea, vomiting, headache, and impaired vision.
Physiotherapy Treatment for Disorders Causing Dizziness and Vertigo
A physiotherapist can provide assessment and treatment, which can help you to improve tolerance in the brain to overcome your dizziness.
The physical assessment will consist of different tests to identify the cause of your dizziness. Based upon the results of the assessment, your treatment plan is created.
At BodyMend, our assessment and treatment protocols are specific for each individual.
Your insurance may or may not require referral from the doctor. As there are a lot of problems which can give rise to dizziness it is very important that you consult your family doctor.
>> Please contact our clinic online or at 905-456-8196 to get more information about vestibular rehabilitation therapy.
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