What is vestibular disorder?

The article was professionally consulted by BSCK II Pham Thi Son - Department of Medical Examination & Internal Medicine, Vinmec General Hospital, Hai Phong.

Vestibular disorders accompanied by a few diseases such as cerebral ischemia, diabetes, high blood pressure ... can be the cause of stroke, threatening the patient's life. So what are vestibular disorders and how are they classified?

The vestibule is the part of the nervous system located behind the cochlea on both sides. The vestibule has a role in balancing the body, maintaining a state of balance in postures, activities, coordinating moving parts such as eyes, hands, feet, torso...
Vestibular disorders are The condition in which the transmission and reception of information of the vestibule is disordered or blocked due to damage to the 8th nerve or the artery supplying the brain, or other lesions in the inner ear and brain area. This causes the vestibule to lose balance, the body staggers, dizziness, dizziness, lightheadedness, tinnitus, nausea... These symptoms are repeated many times and appear suddenly. making patients very uncomfortable, greatly affecting the patient's life and ability to work.

There are two types of vestibular disorders:
2.1. Vestibular disorders of peripheral origin Due to damage to the vestibular system right in the inner ear. Symptoms are often overwhelming, patients are dizzy and lose a lot of balance but are not life-threatening. Most people suffer from this group of diseases
2.2. Vestibular disorders of central origin Central vestibular disorders are caused by lesions of vestibular nuclei in brain stem, cerebellum. This group of diseases is rare, symptoms are not aggressive. However, this group of diseases is often more dangerous and difficult to treat than vestibular diseases with peripheral causes.

3.1. Causes of peripheral vestibular vestibular neuritis: Due to shingles virus, chickenpox, mumps (accounting for about 5% of cases), causing paralysis of the vestibular nerve, leading to dizziness appearing suddenly, lasting for a long time. hours to months without hearing disturbance (other than Meniere's syndrome).
Metabolic disorders: diabetes, uremia, hypothyroidism...
Other causes:
Meniere's syndrome: Inner ear edema Acute and chronic otitis media Inner ear malformation. Injury to the inner ear area VIII nerve tumor Atrial stone. Undesirable effects of drugs (streptomycin, gentamycin...); Alcohol, drugs Motion sickness Eyeball: Double vision 3.2. Central vestibular causes Basal circulatory insufficiency; Orthostatic hypotension; Wallenberg's syndrome; Cerebellar infarction; Multiple sclerosis ; Cerebellar tumor... Migraine headache. Parkinson disease ; Neurosyphilis, 3.3. Some factors increase the risk of vestibular disorders such as: Age: Anyone at any age can have vestibular disorders, but older people are at higher risk than younger people. It is estimated that for every 100 people over the age of 40, about 35 people have vestibular disorders. History of dizziness: People who have experienced dizziness are more likely to experience dizziness, lightheadedness, loss of balance... in the future. Increased risk of vestibular disorders. Note: When there are signs of vestibular disorders mentioned above or any abnormal changes in your body, you need to see a doctor as soon as possible so that the doctor can examine, diagnose and have timely treatment methods. time.

Signs of vestibular disorders depend on the severity of the disease. Each person will experience different symptoms.
4.1. Peripheral vestibular syndrome Systemic vertigo: Objects rotate around the patient or vice versa. The most obvious manifestation is usually when the patient changes position, especially standing up and sitting down suddenly or just waking up.
Body loss of balance, dizziness, head spinning, body staggered, unsteady Visual disturbances: dizziness, vertigo, disorientation Hearing disorders: Tinnitus. When a patient has signs of tinnitus, they must come to the doctor early and treat aggressively. If treated late, the disease leaves sequelae of hearing loss (loss of hearing), or deafness, with the sound of cicadas, crickets .. in the ears, especially at night. vibrating eyeball. Nausea or vomiting Insomnia, fatigue, lack of concentration Lower blood pressure 4.2. Central vestibular syndrome Dizziness: Patients usually do not have severe dizziness, there is a feeling of floating like on a wave. Hearing loss: Tinnitus, hearing loss Multidirectional nystagmus, including longitudinal nystagmus. Walking like a drunkard, the patient usually does not walk in a straight line, or walk in a zigzag pattern. Loss of coordination: The patient cannot do precise movements such as: flipping the hand over, pointing to the nose, etc. Sometimes there is a change in voice when pronouncing certain sounds like “O”.

Electrical testing and use of small electrodes placed on the skin around the eyes, to measure eye movements to evaluate for signs of vestibular dysfunction or neurological problems. Rotational test to evaluate eye and ear function. The test uses video glasses or electrodes to track eye movements. Cochlear acoustic testing provides information about hair cells in the cochlea, by measuring the response of hair cells to clicks produced by a small speaker inserted in the ear canal. uses a magnetic field and radio waves to create cross-sectional images of body tissues to be scanned. Brain MRI can detect tumors, strokes, and other soft tissue abnormalities that can cause dizziness or fainting.

Follow the doctor's instructions, use the correct medicine and the full dose according to the doctor's prescription. The drugs and dosages used for each person are different, depending on the examination and clinical tests to determine the cause and extent of the disease. Practice vestibular rehabilitation exercises. These exercises will help strengthen the coordination of parts of the body, help the brain recognize and process signals from the vestibule more smoothly and rhythmically. Exercise regularly: Exercise helps to improve health, increase blood circulation, and help stabilize blood circulation in the brain. At the same time reduce pressure and stress for patients. Balance between work and rest Have a reasonable diet: Eat a full range of substances, provide enough energy for the body. Eat a lot of vegetables, tubers and fruits; limit fried foods, greasy foods... Perform surgery if necessary: ​​If the treatment measures for vestibular disorders above are not effective, do not improve the patient's condition, the doctor will surgery may be indicated. Vestibular disorder is a condition in which the process of transmitting and receiving information of the vestibule is disturbed or blocked due to damage to the 8th nerve or the artery that nourishes the brain or other lesions in the inner ear area. and brain. The disease can leave dangerous complications and cause stroke. Therefore, when there are signs of vestibular disorders, patients should go to medical centers for examination and treatment.
Vinmec International General Hospital is the address for examination, treatment and prevention of diseases. When performing the examination process at Vinmec, customers will be welcomed and used modern facilities and equipment along with perfect medical services under the guidance and advice of experts. Good doctors, well-trained both at home and abroad.