Vestibulopathy - what is it ... Vestibulopathy: a description, causes and characteristics of treatment

The human body maintains its position in space through the functioning of the vestibular apparatus. The main task of this system is the ability to balance, analyzing the movement and location of the body. The development of vestibular dysfunction is called "vestibulopathy". What is it and what are the main manifestations of the disease, is discussed in the article.

Basic concepts of the disease

Few patients asked themselves the question: "Vestibulopathy - what is it?", Because the disease is not so widespread. This term refers to a complex of disorders of the vestibular apparatus characterized by the inability of the latter to perform its functions and maintain the position of the human body in space.

Vestibulopathy, the symptoms and treatment of which will be discussed further, can develop both as a separate disorder in the body, and as one of the syndromes of another psycho-vegetative disorder. In the second case, the treatment and diagnosis of the disease become more difficult, as it closely intertwines with the overall clinical picture, along with other somatic, vegetative and emotional-affective manifestations.

Disorder of vestibular function may appear at an early age. This pathological condition is considered as an inadequacy of the work of the otolith apparatus. In childhood it manifests itself in the form of motion sickness on a swing, in an elevator, public transport.

Over time, the symptoms of disorders begin to resemble conditioned reflexes. That is, the clinical picture of the attack develops even before the factor has started to act, what causes it.

Etiological factors of the disease

The following causes of vestibular dysfunction occur:

• Diseases of the inner ear;
• Organic brain damage;
• Pathological processes of the cervical spine;
• Traumatic injuries;
• Tumors;
• Infectious diseases;
• Age changes.

Among the diseases of the auditory analyzer, which can cause the development of vestibulopathy, distinguish between labyrinthitis, a labyrinth infarction, Meniere's disease.

Infarction of the labyrinth often occurs against the background of age-related changes. Patients complain of severe hearing loss and the appearance of vestibular disorders.

Ménière's disease is characterized by loss of hearing, nausea, vomiting, dizziness, a feeling of stuffiness and tinnitus. This disease is associated with pathological processes in the inner ear.

The labyrinthite has a bacterial or viral character. The inflammatory process is localized in the membranous labyrinth of the inner ear. In addition, vestibulopathy can be caused by intoxication with toxic substances or medication.

Common manifestations

All forms of this disease have common and specific manifestations. The disease is characterized by the following common symptoms:

1. Vertigo may be temporary or permanent. Each patient has his own, individual perception of dizziness. Some complain about the feeling of impossibility to fix the sight, others - that all objects rotate in one direction.
2. Headache can be manifested by pain of varying strength and intensity.
3. Visual impairment - the patients have flies or dark circles in front of their eyes, eyesight decreases.
4. Disorders from the balance - patients stagger, they may fall, they do not have a sense of stability.
5. Nystagmus - there is a movement of eyeballs, which has a rhythmic character. Eyes can move in any direction.
6. Nausea, vomiting.

Types of vestibular disorders

The following forms of vestibular dysfunction are distinguished:

• Vertebrogenic vestibulopathy;
• Peripheral vestibulopathy;
• Posttraumatic form of vestibular disorder.

Each form of the disease has its own etiological factors, as well as general and specific symptoms of the clinical picture.

According to the ICD, vestibulopathy and all its manifestations have code H81. Relate to the group of diseases of the inner ear (H80-H83).

Vertebrogenic form

This type of vestibular disorders is directly related to pathological processes in the cervical spine. The causes of development can be such violations:

• Osteochondrosis;
• osteoporosis;
• Insolvency of discs or vertebrae;
• Clenching of nerves;
• Disturbance of microcirculation.

The disease is characterized by frequent attacks of dizziness, which can be systematic or rare. When moving or turning the head, patients complain of a feeling of discomfort, a sense of instability. The patient can not focus the look on the subject, there is a feeling of nausea when trying to visual fixation on objects that move.

Some patients develop a central syndrome of vestibulopathy. It has a paroxysmal character and a sharp onset. The patient is disoriented in space, severe dizziness and cephalgia are noted. Vestibulopathy with such manifestations is dangerous for the possibility of complications.

Peripheral form of the disease

Acute peripheral vestibulopathy - what is it? Inflammatory processes in the nerve of the internal course of the auditory analyzer cause the development of this form of the disease. The clinical picture is accompanied by such manifestations:

• Dizziness of a paroxysmal nature;
• Violation of equilibrium;
• Movement of the eyes, independent of the desire of the patient;
• The hearing has not changed.

Etiological factors are still unknown. It is assumed that the jogging mechanism of this form can be bacteria or viruses. Many patients complain of the development of symptoms of an acute respiratory viral infection in a history before the onset of attacks of vestibular disorders.

Peripheral vestibulopathy is manifested by a feeling of fear, nausea, vomiting, long dizziness, noise in one ear and a feeling of stuffiness in it. The level of hearing remains the same.

Complication of this form can become encephalopathy. Vestibulopathy, the treatment of which must begin with the first symptoms, rarely causes such severe complications.

Development of the disease due to trauma

Post-traumatic vestibulopathy - what is it? This is a form of vestibular apparatus disorder caused by traumatic damage to the tympanic membrane, the walls of the labyrinth or nerve tissues.

Etiological factors of development:

• Brain contusion;
• Damage to the skull bones;
• Psychogenic dizziness after trauma;
• Consequences of decompression.

The attack of dizziness is quite long, accompanied by nausea and vomiting, nystagmus, unsteadiness during movement. Symptoms disappear only after a few weeks.

Diagnostic examination

Vestibulopathy, the symptoms of which may be a sign of disorders of the vestibular apparatus or a syndrome of another disease, is fairly easily diagnosed. However, finding out the cause can take a long time.

First of all, the patient is examined by a neurologist. This diagnosis includes ophthalmoscopy, assessment of the condition of the facial and auditory nerve. The work of the remaining groups of nerves is checked, including the symptom of Babinsky.

A palcenosal assay, a knee-heel and a test for dyadochokinesis make it possible to assess the state of the cerebellum.

Also, a magnetic resonance imaging of the cervical spine is assigned to determine the possible development of the vertebral form of the disease. The doctor examines the condition of bones, vertebrae, muscle and joint apparatus.

Obligatory is the consultation of an otorhinolaryngologist with an examination of the condition of the tympanic membrane. In case of traumatic injury, the ENT doctor evaluates the tympanic cavity.

Principles of therapy

Vestibulopathy, whose treatment should be comprehensive, has a favorable outcome in the early circulation of specialized care. In the first place, symptomatic therapy is performed. It includes the use of the following drug groups:

1. Preparations of anticholinergic action inhibit the activity of the vestibular structures. These are preparations based on platyphylline and scopolamine. More often they are used to prevent the appearance of seizures.
2. Antihistamines - "Dramin", "Bonin", "Dimedrol" - pass through the blood-brain barrier.
3. Benzodiazepines are effective in dizziness, inhibit the work of the vestibular apparatus (Relanium, Laurafen, Lorazepam).
4. Preparations with antiemetic action: "Pipolphen, Metatherinum", "Cerucal", "Metoclopramide", "Motilium".

During the periods of remission, you can use the elements of manual therapy, massage, reflexology, treatment with leeches, magnetotherapy and other possible methods.

Vestibular rehabilitation

This is a specially designed set of measures aimed at the speedy restoration of the normal operation of the vestibular apparatus. The main point of the program is gymnastics and gait training.

Conducting vestibular gymnastics is permissible only in those cases when there is no progression of the disease. It is indicated when the patient is in a stable condition. The earlier the gymnastic exercises begin, the more effective the result will be.

The principle of vestibular gymnastics is carrying out exercises in which the movements of the trunk, head and eyes are sensory inconsistent. At first the patient feels a sense of discomfort when performing, but soon gets used to it.

The patient learns to walk with his eyes closed, stand on one leg, throw his head back, alternately opening and closing his eyes, stand with his eyes closed on one knee.

Preventive measures

The development of dizziness attacks can be prevented by adhering to certain preventive measures. You should eat right, exercise, alternate between rest and work. It is also necessary to treat diseases in time, which can serve as an impetus to the development of vestibulopathy. These are diseases of the brain, nervous system, spine, ENT disease.

Vestibulopathy, the symptoms and treatment of which you now know, can be corrected and treated with the timely detection of the cause of the disease and seeking help from a doctor.