The human body maintains its position in space through the functioning of the vestibular apparatus. The main objective 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, is considered in the article.
Disease Concepts
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 later, can develop as a separate disorder in the body, and as one of the syndromes of another psycho-vegetative disorder. In the second case, treatment and diagnosis of the disease become more difficult, as it is closely interwoven with the overall clinical picture, along with other somatic, autonomic and emotional-affective manifestations.
Disorders of vestibular function can occur at an early age. This pathological condition is considered as the failure of the otolith 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 the disorder begin to resemble conditioned reflexes. That is, the clinical picture of the 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 injuries;
- tumors;
- infectious diseases;
- age-related changes.
Among the diseases of the auditory analyzer that can cause the development of vestibulopathy, there are labyrinthitis, myocardial labyrinth, and Meniere's disease.
Maze infarction often occurs against a background of age-related changes. Patients complain of severe hearing loss and the appearance of vestibular disorders.
Meniere's disease is characterized by hearing loss, nausea, vomiting, dizziness, a feeling of 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.
Common manifestations
All forms of this disease have general and specific manifestations. The disease is characterized by the following general symptoms:
- Dizziness may be temporary or permanent. Each patient has his own, individual perception of dizziness. Some complain about the feeling of impossibility to fix the gaze, while others complain that all objects rotate in one direction.
- Headache can be manifested by pain of varying strength and intensity.
- Visual impairment - patients have flies or dark circles in front of their eyes, vision is reduced.
- Imbalance - patients stagger, may fall, they do not have a sense of stability.
- Nystagmus - there is a movement of the eyeballs, which has a rhythmic character. 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.
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 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 reasons for the development may be such violations:
- osteochondrosis;
- osteoporosis;
- failure of the discs or vertebrae;
- nerve compression;
- violation of microcirculation.
The disease is characterized by frequent bouts 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 his eyes on the subject, a feeling of nausea appears when trying to visually fix on objects that are moving.
Some patients develop central vestibulopathy syndrome. It has a paroxysmal character and an acute onset. The patient is disoriented in space, severe dizziness and cephalalgia are noted. Vestibulopathy with similar manifestations is dangerous with 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:
- paroxysmal dizziness;
- imbalance;
- eye movement, independent of the patient's desire;
- hearing has no changes.
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 acute respiratory viral infection prior to the onset of vestibular disorder.
Peripheral vestibulopathy is manifested by a feeling of fear, nausea, vomiting, prolonged dizziness, noise in one ear and a feeling of stuffiness in it. The level of hearing remains the same.
Encephalopathy can become a complication of this form. Vestibulopathy, the treatment of which must be started at the first symptoms, rarely causes such serious complications.
The development of the 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, the wall of the labyrinth or nerve tissue.
Etiological factors of development:
- brain contusion;
- damage to the bones of the skull;
- psychogenic dizziness after trauma;
- consequences of decompression.
The dizziness attack is quite long, accompanied by nausea and vomiting, nystagmus, instability during movement. Symptoms disappear after only a few weeks.
Diagnostic examination
Vestibulopathy, the symptoms of which can be a sign of disorders of the vestibular apparatus or a syndrome of another disease, is easily diagnosed. However, finding out the cause may take a long time.
First of all, a patient is examined by a neurologist. This diagnosis includes ophthalmoscopy, an assessment of the state of the facial and auditory nerve. The work of the remaining groups of nerves, including the Babinsky symptom, is checked.
A palatine test, a knee-calcaneal test, and a test for diadochokinesis make it possible 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 bones, vertebrae, muscle and articular apparatus.
Mandatory is the consultation of the otorhinolaryngologist with an examination of the condition of the eardrum. In the case of traumatic injury, the ENT doctor evaluates the tympanic cavity.
Principles of Therapy
Vestibulopathy, the treatment of which should be comprehensive, has a favorable outcome with early access to specialized care. First of all, symptomatic therapy is performed. It includes the use of the following groups of drugs:
- Anticholinergic drugs inhibit the activity of vestibular structures. These are drugs based on platyphyllin and scopolamine. Most often they are used to prevent seizures.
- Antihistamines - "Dramin", "Bonin", "Diphenhydramine" - 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.
During 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 developed 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.
Carrying out vestibular gymnastics is permissible only in those cases when there is no progression of the disease. It is indicated in a stable condition of the patient. The sooner gymnastic exercises begin, the more effective the result will be.
The principle of vestibular gymnastics is to conduct exercises in which the movements of the trunk, head and eyes are sensoryly 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.
Preventative 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 timely treat diseases that can serve as an impetus for 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 timely identification of the cause of the disease and seek the help of a doctor.