ABOUT BALANCE, DIZZINESS & VESTIBULAR DISORDERS

PERIPHERAL VESTIBULAR SYSTEM

 

The peripheral vestibular system includes sructures in the inner ear, specifically the semicircular canals, utricle, and saccule, which are responsible for detecting motion and spatial orientation. These structures send signal through the vestibular nerve to the brainstem, where the body processes balance and eye movements. 

When there is dysfunction in this system - due to infection, injurym or degeneration - it can result in vertigo, imbalance, and nausea.

EAR ANATOMY 

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The ear has three main sections:

• Outer ear - collects sound

• Middle ear - transmits sound through the eardrum and ossicles 

• Inner ear - contains the cochlea (hearing) and vestibular system (balance 

      The inner ear's vestibular portion includes:​ 

• Semicircular canals - detect rotational movements 

• Otolith organs (utricle and saccule) - detect linear acceleration and gravity.

VESTIBULAR DISORDERS: AN OVERVIEW

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The vestibular system helps control balance, posture, and stable vision. When it's damaged due to infection, injury, degeneration, or tumors - it can lead to symptoms like:

• Vertigo 

• Imbalance

• Motion Sensitivity 

• Nausea 

• Difficulty focusing

Common diagnostic tests include VNG, rotational chair testing, posturography, and MRI or CT scans. Treatment may involve vestibular rehabilitation (VRT), medication or in some cases, surgery.​

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HOW DO I KNOW IF I HAVE A VESTIBULAR DISORDER?

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It's important to recognize the different types of sensations that fall under "Dizziness." Ask yourself:

• Do I feel like the room is spinning (vertigo)?

• Do I feel unsteady on my feet?

• Do I have trouble focusing on tracking movement?

• Do my symptoms get worse with head movement?

If you answered yes to any of these, or if your Dizziness is persistent, you should seek an evaluation from a healthcare provider - especially a physical therapist or doctor specializing in balance disorders.  ​

CENTRAL VESTIBULAR DISORDERS​

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The central vestibular system includes the brainstem, cerebellum, and cerebral cortex. It processes information received from the peripheral vestibular system and integrates it with input from vision and proprioception (sensation from joints and muscles). Disorders affecting the central system - such as stroke multiple sclerosis, or brain injury - can result in more complex symptoms like severe imbalance, difficulty focusing, double vision, and neurological signs (e.g., weakness or slurred speech) 

Distinguishing between peripheral and central causes of dizziness is crucial for proper diagnosis and treatment.

CAUSES OF DIZZINESS 

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Dizziness can feel like:

• Vertigo - the sensation that you or your surrounding are spinning 

• Disequilibrium - a sense of unsteadiness or imbalance

• Lightheadedness - feeling a faint or about to pass out

Common Causes include: ​

• Benign Paroxysmal Positional Vertigo (BPPV)

• Vestibular neuritis or labyrinthitis 

• Menieres Disease 

• Migraines

• Anxiety

• Low Blood Pressure 

• Medication Side Effects

VESTIBULAR INJURY: COMPENSATION, DECOMPENSATION, AND FAILURE TO COMPENSATE

When the vestibular system is injury, the brain attempts to compensate by adjusting to the altered signals. This natural recovery process can occur in two stages:

• Acute Compensation - short-term adjustments after injury 

• Chronic compensation - long-term neurological adaptation

Sometimes compensations fails or regresses, often due to:​

• Stress

• Illness 

• Inactivity

• Lack of vestibular rehabilitation

In such cases, symptoms may return or worsen. Vestibular Rehabilitation therapy (VRT) - a specialized form of physical therapy - can help retrain the brain to interpret balance signals correctly. In some cases, medications may be used temporarily to reduce symptoms.​

POSSIBLE SYMPTOMS OF A VESTIBULAR DISORDER 

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Symptoms can affect multiple areas of functioning and may include:

Balance and Mobility 

• Unsteadiness

• Falls or near-falls 

• Difficulty walking in the dark or on uneven surfaces

Vision ​

• Blurred Vision 

• Difficulty focusing

• Sensitibity to light or busy enviroments

Hearing ​

• Tinnitus (ringing)

• Hearing loss

• Ear pressure or fullness

Cognitive and Emotional Effects 

• Difficulty concentrating 

• fatigue

• Anxiety or panic attacks