Vestibular Disorders: Symptoms, Causes, Treatment

Overview

Vestibular disorders are a kind of condition which affects the vestibular apparatus, further affecting orientation and bodily coordination. The vestibular system in our body includes the parts of the inner ear and brain that process the sensory information, which helps us coordinate and balance ourselves according to spatial position and gravity. Humans, cats and dogs are the most common species affected by this condition.

The most common vestibular disorders include:

  • benign paroxysmal positional vertigo (BPPV)
  • labyrinthitis and vestibular neuritis
  • Ménière’s disease
  • secondary endolymphatic hydrops
  • perilymph fistula

It is estimated that about 35% of adults aged 40 years or older in the United States, approximately 69 million Americans, have suffered from some form of vestibular disorder.

Causes

Vestibular disorders are most commonly caused by head injury, aging, and viral infection. Other illnesses, as well as genetic and environmental factors, may also cause or contribute to vestibular disorders. Besides, vestibular disorders may also be the side effect of certain medications.

Symptoms

The specific signs and symptoms of vestibular disorders vary depending on the types of condition. There are some common symptoms:

  • Vertigo and dizziness
  • Imbalance and spatial disorientation
  • Prone to falling
  • Going in circles
  • Rolling
  • Stumbling
  • Vision disturbance
  • Hearing changes
  • Cognitive and psychological changes

Diagnosis

To diagnose different types of vestibular disorders, doctors may first conduct a physical examination and get basic information from a patient’s medical history. The doctors may also order some diagnostic tests to assess the vestibular system function and to rule out the causes of symptoms, which might include:

  • Electronystagmography (ENG). It uses small electrodes placed over the skin around the eyes during testing. The electrodes can measure eye movements to evaluate signs of vestibular dysfunction or neurological problems.
  • Videonystagmography (VNG). It uses goggles with video cameras to monitor eyes. The video cameras can also measure eye movements to evaluate signs of vestibular disorders.
  • Rotation tests. It can evaluate how well the eyes and inner ear work together. The tests also use video goggles or electrodes to monitor eye movements. The head is rotated side to side at moderate or slow speeds, and associated eye movements are analyzed.
  • Audiometry. It measures hearing function. Hearing evaluation is an important part of vestibular diagnosis, because the inner ear contains both hearing and balance organs.
  • Video head impulse testing (VHIT). It also evaluates how well the eyes and inner ears work together. A small set of glasses with a camera is used to monitor eye movements.

Treatment

The treatment for vestibular disorders may depend upon symptoms, medical history and general health and the diagnostic results of the patients.

  • Vestibular rehabilitation therapy (VRT)

VRT is an exercise-based program used to alleviate both the primary and secondary problems caused by vestibular disorders. In this test, specific head, body, and eye exercises are conducted to retrain the brain to recognize and process signals from the vestibular system and coordinate them with information from vision and proprioception.

  • Canalith repositioning maneuvers

It is a specialized form of VRT used to treat benign paroxysmal positional vertigo (BPPV). The most common type is Epley maneuver, which involves a series of specifically patterned head and trunk movements to move tiny displaced otoliths to a place in the inner ear.

  • Home remedy

Dietary adjustments. It is found that certain modifications in diet are helpful in managing Ménière’s disease, secondary endolymphatic hydrops, and migraine-associated dizziness. For instance, stop eating non-dietary substances such as nicotine, which may reduce some symptoms.

Medication. The use of medication can treat vestibular disorders. Examples of vestibular suppressants are meclizine, dimenhydrinate, lorazepam and diazepam. Other medications that may be prescribed are steroids, antiviral drugs or antibiotics.

  • Surgery

When the medical treatments do not work in managing vertigo and other symptoms of vestibular disorders, surgery may be considered. Surgical procedures for peripheral vestibular disorders can be corrective or destructive. Corrective surgery is used to repair or stabilize inner ear function. Destructive surgery is used to stop the production of sensory information or prevent its transmission from the inner ear to the brain.


Keywords: vestibular disorders.

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.