Introduction |
CausesDisruption along any portion of the anatomical pathway described above can affect one’s perception of balance or equilibrium. A problem with the inner ear portion of the pathway or the sensory information being relayed to the brain via the vestibulocochlear nerve is termed a peripheral vestibular disorder. If the problem affecting one’s balance is due to damage of a structure within the brain itself, which then affects the reception and integration of balance information, it is termed a central vestibular disorder. Benign Paroxysmal Positional VertigoBenign paroxysmal positional vertigo (BPPV) is a common clinical disorder of balance, which is characterized by recurrent vertigo spells that are brief in nature (usually 10-60 seconds) and are most often triggered by certain head positions. Benign, in medical terms, means it is not threatening to life. Paroxysmal means it comes with a rapid and sudden onset or increase in symptoms. Vestibular Neuronitis or LabyrinthitisVestibular neuronitis or labyrinthitis is an inflammation of the inner ear or its associated nerve (the vestibular portion of the vestibulocochlear nerve), which causes vertigo. Hearing may also be affected if the infection affects both portions of the vestibulocochlear nerve. Meniere's DiseaseMeniere's disease is a chronic incurable vestibular disorder characterized by symptoms of episodic severe vertigo, fluctuating hearing loss, ear ‘fullness’ and/or ringing in the ear (tinnitus), and nystagmus. Migraine Associated VertigoSome patients who suffer from migraines (approximately 25-35%) experience migraine associated vertigo (MAV). MAV, (also called a vestibular migraine), may also be accompanied by nausea or vomiting and may last a few seconds or a few days. Other vestibular symptoms may also be noted in association such as motion intolerance, sensitivity to head movement, dizziness, a feeling of pressure in the ears, imbalance and spatial disorientation. With MAV the symptom of vertigo may precede the onset of the migraine or may appear as the headache pain develops. Vertigo may also occur during a headache-free time frame. Some patients will also present with a true BPPV after the migraine event has ceased. Acoustic NeuromaAn acoustic neuroma is a benign (non-cancerous) tumour on the vestibulocochlear nerve. Early symptoms are related to loss of hearing in the affected ear, ringing in the ear (tinnitus), dizziness, and a feeling of fullness in the ear. The tumour is slow growing so symptoms come on gradually and may be easily overlooked in the early stages. As the tumour grows it may push on other nerves in the area and symptoms such as headaches or pain and numbness in the face may appear. Vertigo or other balance issues may arise with growth of the tumour. Vertigo as a symptom of Multiple SclerosisMultiple Sclerosis (MS), which causes a demylenation of nerves, primarily attacks the cerebellum of the brain, as well as the brain stem (including the cranial nerves such as the vestibulocochlear nerve), and the spinal cord. The cerebellum is particularly important in regards to balance as it helps to integrate information received by the brain in order to both maintain balance and arrange coordinated movements. Damage to either the cerebellum and/or the vestibulocochlear nerve due to MS can cause vertigo. Other causes of VertigoAlthough most cases of vertigo are related to peripheral or central vestibular disorders, other causes of vertigo may be identified such as alcohol intoxication, metabolic disorders, bacterial or viral infections, side-effects from medications, or side effects from overexposure to specific chemicals (ototoxicity). Even severe emotional issues causing anxiety can manifest in vertigo. In some rare cases, however, a cause for the symptom of vertigo goes unknown. |