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 maintain balance by 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, 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. A similar 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 below, can develop both as a separate disorder in the body and inthe form of one of the syndromes of another psychovegetative disorder. In the second case, the treatment and diagnosis of the disease become more difficult, since it is closely intertwined with the overall clinical picture along with other somatic, vegetative and emotional-affective manifestations.
Vestibular dysfunction can also appear at an early age. This pathological condition is considered as the failure of the otolithic apparatus. In childhood, this 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 an attack develops even before the factor that causes it begins to act.
Etiological factors of the disease
The following causes of vestibular dysfunction are distinguished:
- diseases of the inner ear;
- organic brain damage;
- pathological processes of the cervical spine;
- traumatic injury;
- tumors;
- infectious diseases;
- age-related changes.
Among the diseases of the auditory analyzer that can cause the development of vestibulopathy, there are labyrinthitis, labyrinth infarction, Meniere's disease.
Labyrinth infarction 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 hearing loss, nausea,vomiting, dizziness, stuffiness and tinnitus. This disease is associated with pathological processes in the inner ear.
Labyrinthitis is bacterial or viral in nature. 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 medications.
General manifestations
All forms of this disease have common and specific manifestations. The disease is characterized by the following general symptoms:
- Dizziness can be temporary or permanent. Each patient has their own individual perception of dizziness. Some complain about the feeling of being unable to fix their eyes, others - that all objects rotate in one direction.
- Headache can manifest itself as pain of varying strength and intensity.
- Impaired vision - patients have flies or dark circles before the eyes, vision is reduced.
- Balance disorders - patients stagger, may fall, have no sense of stability.
- Nystagmus - there is a movement of the eyeballs, which has a rhythmic character. The eyes can move in any direction.
- Nausea, vomiting.
Types of vestibular disorders
The following forms of vestibular dysfunction are distinguished:
- vertebrogenic vestibulopathy;
- acute peripheral vestibulopathy;
- post-traumatic form of vestibular disorder.
For eachforms of the disease are characterized by their etiological factors, as well as general and specific symptoms of the clinical picture.
According to the ICD, vestibulopathy and all its manifestations have the code H81. They belong 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 may be such violations:
- osteochondrosis;
- osteoporosis;
- failure of discs or vertebrae;
- nerve constriction;
- violation of microcirculation.
The disease is characterized by frequent attacks of dizziness, which may be systematic or rare. When moving or turning the head, patients complain of a feeling of discomfort, a feeling of instability. The patient cannot focus on the object, there is a feeling of nausea when trying to visually fixate on moving objects.
Some patients develop central vestibulopathy syndrome. It has a paroxysmal character and an acute onset. The patient is disoriented in space, there is severe dizziness and cephalgia. Vestibulopathy with similar manifestations is dangerous with the possibility of developing 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 the following manifestations:
- paroxysmal dizziness;
- disbalance;
- eye movement, independent of the patient's desire;
- the rumor has not changed.
Etiological factors are still unknown. It is assumed that the push mechanism of this form may be bacteria or viruses. Many patients complain of a history of developing symptoms of an acute respiratory viral infection before the onset of attacks of vestibular disorders.
Peripheral vestibulopathy is manifested by a feeling of fear, nausea, vomiting, prolonged dizziness, noise in one ear and a feeling of congestion in it. Hearing level remains the same.
Encephalopathy can become a complication of this form. Vestibulopathy, which should be treated at the first symptoms, rarely causes such severe complications.
Development of disease due to injury
Post-traumatic vestibulopathy - what is it? This is a form of disorder of the vestibular apparatus, the cause of which is traumatic damage to the eardrum, labyrinth wall or nerve tissues.
Etiological factors of development:
- brain injury;
- damage to the bones of the skull;
- psychogenic dizziness after injury;
- decompression consequences.
The attack of dizziness is quite long, accompanied by nausea and vomiting, nystagmus, unsteadiness when moving. 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 easy to diagnose. However, it may take a long time to figure out the cause.
First of all, the patient is examined by a neurologist. This diagnosis includes ophthalmoscopy, assessment of the state of the facial and auditory nerves. The work of other groups of nerves is checked, including Babinski's symptom.
The finger-nose test, knee-calcaneal test and the diadochokinesis test allow you to assess the state of the cerebellum.
Magnetic resonance imaging of the cervical spine is also prescribed to determine the possible development of the vertebral form of the disease. The doctor examines the condition of the bones, vertebrae, muscular and articular apparatus.
Mandatory is a consultation with an otorhinolaryngologist with an examination of the condition of the eardrum. In case of traumatic injury, the ENT doctor evaluates the tympanic cavity.
Principles of Therapy
Vestibulopathy, which should be treated comprehensively, has a favorable outcome with early referral for specialized care. First of all, symptomatic therapy is carried out. It includes the use of the following drug groups:
- Anticholinergic drugs inhibit the activity of vestibular structures. These are drugs based on platifillin and scopolamine. More often they are used to prevent seizures.
- Antihistamines - "Dramin", "Bonin", "Dimedrol" - pass through the blood-brain barrier.
- Benzodiazepines are effective for dizziness, inhibit the functioning of the vestibular apparatus (Relanium, Lorafen, Lorazepam).
- Antiemetic drugs: Pipolfen, Meterazin, Cerucal, Metoclopramide, Motilium.
In periods of remission, elements of manual therapy, massage, reflexology, leech therapy, magnetotherapy and other possible methods can be used.
Vestibular rehabilitation
This is a specially designed set of measures aimed at the speedy restoration of the normal functioning of the vestibular apparatus. The highlight of the program is gymnastics and gait training.
Vestibular gymnastics is permissible only in cases where there is no progression of the disease. It is indicated in the stable condition of the patient. The sooner the gymnastic exercises begin, the more effective the result will be.
The principle of vestibular gymnastics is to perform exercises in which the movements of the torso, head and eyes are sensory inconsistent. At first, the patient feels a feeling of discomfort when performing, but soon gets used to it.
The patient learns to walk with his eyes closed, stand on one leg, tilt his head back, alternately opening and closing his eyes,stand with closed eyes on one knee.
Preventive measures
The development of dizziness attacks can be prevented by adhering to certain preventive measures. You should eat right, play sports, alternate modes of rest and work. It is also necessary to treat diseases in time that can serve as an impetus for the development of vestibulopathy. These are diseases of the brain, nervous system, spine, ENT diseases.
Vestibulopathy, the symptoms and treatment of which you now know, can be corrected and treated with timely identification of the cause of the disease and seeking medical help.
