You might remember in 2022’s September issue that I shared my experience with the vestibular disorder BPPV (Benign Paroxysmal Positional Vertigo), as part of Balance Awareness Week.
It’s that time of year again, with Balance Awareness Week running from September 17-23. It is not something that gets a lot of traction here in Australia, and recently I have encountered a few people wading through various vestibular disorders, trying to navigate which medical professionals they should see, how on earth they describe their symptoms, and battling what is one of the ‘invisible illnesses’. From the outside, you look fine, but your head can be a swirling mess!
The following information, thanks to Vestibular Disorders Association (VeDA), defines what the vestibular system is, and the symptoms that might occur if it is damaged.
The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders can result, and are often associated with one or more of these symptoms, among others:
Dizziness: A sensation of lightheadedness, faintness, or unsteadiness.
Imbalance: Unsteadiness or loss of equilibrium that is often accompanied by spatial disorientation.
Vertigo: A rotational, spinning component, and is the perception of movement, either of the self or surrounding objects.
Brain fog: When the brain is dedicating a great deal of energy to maintain equilibrium and stay steady, activities such as recalling details or short-term memory may become more difficult, and thinking might seem “slow”.
Tinnitus: Abnormal noise perceived in one or both ears or in the head. May be intermittent or continuous and can be experienced as a ringing, hissing, whistling, buzzing, or clicking sound and can vary in pitch from a low roar to a high squeal.
Hearing loss: Reduction in the ability to hear sounds is a common symptom of many vestibular disorders. When VeDA conducted a patient poll, over two thirds reported that they had hearing loss in one or both ears.
Vision impairment: The link between the vestibular system and vision, vestibulo-ocular reflex (VOR), is described in detail with information on evaluation, treatment, coping strategies, and potential solutions for vision correction, including glasses and contact lenses.
Nausea: The feeling of being nauseated.
Cognitive changes: Difficulty thinking, paying attention/concentrating, recalling basic facts (such as your own phone number), short-term memory loss, etc.
Psychological changes: Due to the unpredictable nature of symptoms and the chronic nature of most disorders, vestibular patients tend to suffer from anxiety and/or depression.
Motion sickness: Symptoms appear when the central nervous system receives conflicting messages from the visual system and the vestibular system in the inner ears.
Derealization: Includes feelings of being alienated from or unfamiliar with your surroundings, emotionally disconnected from people you care about, and/or distortions in time or size and shape of objects.
Depersonalization: Feelings that you’re an outside observer of your thoughts, feelings, your body or parts of your body; emotional numbness.
If you have any of these, the cause might be a vestibular issue (if these are accompanied by more serious symptoms, such as chest pain, high fever, shortness of breath or severe headache seek immediate medical attention).
The most commonly diagnosed vestibular disorders include benign paroxysmal positional vertigo, labyrinthitis or vestibular neuritis, Ménière’s disease, and secondary endolymphatic hydrops. Your first port of call should be a GP for diagnosis and to check for underlying conditions, then your options for further testing include an ear, nose and throat specialist, neurologist, or audiologist.
An allied health professional, such as a physiotherapist or chiropractor, with comprehensive vestibular training, is likely to be your best bet for resolution and ongoing management of a vestibular disorder.
Once the initial issue is resolved, some vestibular rehabilitation therapy, most of which is conducted at home after initial instruction, might be needed to reset the brain back to its pre-dizzy self.
You can find more information at the VeDA website, vestibular.org.
