The vestibular apparatus. Violations of the symptoms, the treatment of adults, children and newborns

Vestibular system is responsible for balance, posture and preservation of motion in space. Violation of its functions and simtomy vestibulopathy found among elderly patients in each case 2-3. Young patients were treated with similar symptoms less often.

The function of the vestibular apparatus

The vestibular apparatus is represented by human receptors organ of Corti and otolith membrane located in middle ear as well as in the nuclei of brain structures, conductive paths and neocortex (bark cerebral hemispheres brain). Each of these important constituents of the vestibular analyzer system is doing its task.

The function that performs the vestibular apparatus, reduced to balance the preservation of due control over the tone of the muscles of the trunk and extremities.

Information on the status of the human body as a whole and its individual parts comes just from the receptive field of the analyzer in cortical - cortical temporal area office system. After synthesis begins its processing actions that can be reduced to a change in body position, movement of certain muscle groups, and also the realization of the autonomic nervous system reactions.

The vestibular apparatus (disorder symptoms which occur in various combinations, can be caused by a variety of factors) allows a person to keep the balance even with your eyes closed or darkness.
Causes and symptoms of disorders of vestibular function

The most frequent manifestation of vestibular syndrome - dizziness or vertigo. It is of two types - systemic and extra-systemic. In the first case, the patients experience and see objects revolving around him. Non-systemic vertigo manifested unsteadiness in walking, uneven gait, rocking from side to side as in walking and in a static position.

Allocate another classification of vertigo. It is based on the frequency of occurrence of symptoms. Chronic dizziness, which is also called persistent, has a permanent character. Patients constantly haunted by the feeling of rotation.

In is based on vascular pathology, tumors in the skull, sometimes intoxication syndrome. In paroxysmal vertigo symptoms of paroxysmal, short-term, usually initiated by any situation. On incidental during the feeling of fear. Patients are afraid to go, because you can lose your balance and fall off at some point.

In addition to various of the following symptoms occur on the intensity of vertigo:

gastrointestinal symptoms	nausea; vomiting; diarrhea or constipation sudden.
Cardiac (sedechno-vascular) displays	increased heart rate, irregular heartbeat (arrhythmia); dyspnea; discomfort in the chest; unstable blood pressure; sweating; pallor.
visual impairment	violation of the focus; dimness before the eyes; "Flickering flies"; change in pupil diameter; anisocoria; change in visual acuity; bleary eyes.
hearing disorders	noise in ears; deafness; headache; tinnitus.
neuropsychiatric manifestations	depression; apathy; weakness; unmotivated fatigue; speech changes; anxiety; fear; nystagmus; tremor; shiver; decreased alertness; concentration deterioration.

In children, the symptoms of vestibular disorders occur against the backdrop of rise in body temperature. Adult patients note the presence of flip-flops in paroxysmal form - visual, auditory stimuli. Vestibular syndrome in case of failure in the soimennogo analyzer (device) and various violations include all of the symptoms.

It is important to clarify the cause and treat it to understand how and when they arose, in what order, to pay attention to other important clinical characteristics. In the interictal period feel with episodic vertigo does not suffer. Chronic dizziness is not usually periods of improvement.

Among the reasons - many different diseases and conditions. The first reason may be the presence of pathology at the level of the vestibular nerve-vohleo when inflammation. This condition excludes priority.
vestibular neuritis

We are talking about the inflammatory lesions of the 8th cranial nerve, namely ulitkovo-vestibular. Another name for the disease - the vestibular neurons.

Among the reasons are the following possible factors:

• CNS;
• viral invasion;
• fungal infection;
• intoxication medicines;
• traumatic effect.

Evident in patients in the age range from 30 to 50 years. With infectious genesis to the fore symptoms of intoxication syndrome. It marked weakness, rise in body temperature. The main complaint with neuritis associated with sudden attacks of vertigo advancing.

As a rule, they are accompanied by nausea and vomiting, which does not bring relief. seizure duration lasts depending on the severity of the clinical picture and severity of the disease. This can be a five-minute state, and can disturb and two - three days.

Strengthening vertigo occurs when trying to make head turns, change of body position. Therefore, from the first day of the disease the patient is very difficult to even get out of bed. On average, 4 chasa condition improves independently. If during treatment with not getting any better, dizziness becomes chronic.

From time to time the condition worsens, even against the background of adequate treatment.

Auditory function, despite the common localization with vestibular neurons are not affected. Besides vertigo patients worried about the rise in body temperature, which is typical of infection in the nerve ganglia. Intoxication is manifested by general weakness, pronounced decrease in exercise tolerance.

The vestibular apparatus (disorders symptoms may relate to the autonomic nervous system) in lesions causing unstable blood pressure and increased heart rate when stored properly sinus rhythm. Muscular disorders are as tremor (melkorazmashisty), occurrence of seizures. Possible violations of the sensitivity of the type of paresthesias, tingling.

To avoid this disease should consult an ophthalmologist, neurologist and ENT doctor. Eye doctor assesses the state of the visual analyzer, the eyeballs. The last in the presence of neyronita vestibular nerve twitching rhythmically as in nystagmus. This is another argument in favor of the presence of vestibular neyronita.

The doctor - a neurologist in the identification of such complaints and anamnesis data should exclude not only neurons but also the presence of brainstem stroke. It uses computer tomography, if necessary - with the use of contrast.

In terms of differential diagnosis is very significant holding caloric tests. It deals exclusively with ENT or otonevrologa. Locked response to entering the ear canal (middle ear) varying fluid temperature. It is best to evaluate the movement of the eyeballs whether or nystagmus nistagmoidnoy reaction.

An integrated approach to treatment. Used dietary advice, exercise for the eyes and head, as well as drug therapy.

In addition to symptomatic treatment using an anti-hormone therapy. Methylprednisolone intravenously administered in high doses. To speed recovery vestibular analyzer function or Vestibo Tanakan used in standard therapeutic dosages.

DPPG

It is benign paroxysmal positional vertigo (dizziness). Hence the abbreviation DPPG.Vestibulyarny apparatus disorders, the symptoms of which in this case are similar to neyronitom, has pronounced. This dizzy spells that occur when certain movements of the head and neck.

Episode short, lasts no more than half a minute. accompanied by nausea. Also, there is a hearing loss in which there is no noise. That is why the disease is called benign. Differential-diagnostic tests Dix-Hallpike allows you to confirm the disease. The treatment takes otonevrologa.

Meniere's disease

It is yet another disease which is accompanied by systemic vertigo as paroxysms. Since this affected the inner ear, vestibular unlike neyronita arise hearing impairment.

For the clinical diagnosis is enough to remember the triad of symptoms Prosper Meniere:

• attacks of vertigo;
• unilateral tinnitus;
• hearing loss.

Dizziness with Meniere's disease has clear features. Seizures occur against a background of good health, usually without warning. At least - after the occurrence of stuffiness feeling ear with one hand or noise. There is no dependence on the time of day or any triggers.

Vertigo episode lasts from 4 to 6 hours. Diagnostically significant clinically considered seizures of more than 20 minutes, but stops within 12 hours, no longer. Dizziness stops spontaneously without the application of drugs.

Of autonomic responses that accompany an attack of vertigo at the forefront of nausea and vomiting.

Also observed a unilateral hearing loss. The rumor is broken only by the defeat. Sensorineural hearing loss in Meniere's disease corresponds to the so-called fluctuating (oscillating) the nature of which is confirmed during studies Audiographic.

Clear horizontal type audiological curve. Sometimes defined ascending option. Both of them speak of scalar sensorineural hearing loss. Noise is also one-sided. Determined by the average patient or bass. He is a regular, but amplified to a vertigo attack or his background.

There are 3 types of the course of Meniere's disease:

options	Which all affected auditory function	Which all affected vestibular function
The classic version	simultaneously	simultaneously
cochlear form	first	in the second
vestibular form	in the second	first

Among the necessary tests required to conduct acumetry. It should include kamertonalnye samples, as well as study of the function of hearing conversational speech and whisper. Of specific probes - test Luscher. In a specialized hospital feasible posturography and impedancemetry.

ENT - physician should determine the thresholds of sensitivity to ultrasound and lateralization. The vestibular apparatus (disorders symptoms, coupled with a history suggest a form of developing pathology) in Meniere's disease amenable instrumental examination.

Additional treatments isolated conservative and surgical.

Use tools for quick relief of an attack - Atropine, diphenhydramine, clonazepam, meklozin. For a course of reception to restore vestibular analyzer functions take Betahistine, Vestibo. Course helps Acetazolamide. It is a diuretic, it is sufficient to take for 3 days in a month.

Additional surgical techniques used labyrinthectomy (labyrinth deletion), including partial labyrinthectomy, neurectomy (removal ganglia), endolymphatic shunt sakulyusa, laser impact on the receptor apparatus maze.

Intoxication

There is going to poison medicines, technical ototropnymi fluids and alcohol. Distinguish different groups of substances that can cause intoxication violation of vestibular function. This primarily organic and inorganic poisons industrial origin.

These include silver, lead, nitrobenzene, mercury, nicotine and aniline. This liquid and dense compound. Not less damage in systemic exposure to the substance have in a gaseous aggregate state. This carbon monoxide and acetylene. Sometimes described also illuminating gas.

It is important to remember the household poisons.

Greater affinity for the inner ear tissues has alcohol. This group includes nicotine and botulin. Last found in improperly canned foods stored. Among drugs ototropnym action has arsenic and salicylates. Previously used Quinine can rarely find today.

Injuries and otosclerosis

Otosclerosis is a pathological process of destruction of normal tissue of the inner ear and its simultaneous substitution denser tissue. It may be primary in the framework of a genetically inherited disease, and as a result of trauma.

Clinically, the disease is also manifested by the triad traits. These include hearing loss in the first place. Without this symptom can not be put otosclerosis. Unlike Meniere's disease is a bilateral disease. Complete deafness had not developed, the patient himself has always hears.

Hearing deteriorates during meals and high concentration. But in noisy circumstances, there is a paradoxical improvement in hearing. Tinnitus is very poorly tolerated. Reminds noise of leaves or dripping water.

Sound effects are permanent, but aggravated by a cold, physical exertion, sports, during the reception of alcohol. Noise interferes with reception food and socializing with people. Dizziness is rarer. This is usually positional vertigo, which occurs only in certain positions of the head and neck when cornering.

Multiple sclerosis

Demyelinating disease, which is called the chameleon among the neurological diseases. It develops for unknown reasons. But the pathogenesis is still a disease that develops autoimmune scenario.

The first manifestations usually involve visual disturbances. There are fields of vision loss, blurred and defocusing.

Among the complaints related to violation of the vestibular function, worried dizziness and unsteadiness when walking. Often you will notice small- or krupnorazmashisty tremor of the upper extremities. Autonomic symptoms relate heart rate and blood pressure.

They can join focal signs and disorders of pelvic functions. There is no specific treatment. Used symptomatic correction, use hormones, immunosuppressants. Variants on the use of monoclonal antibodies in the treatment of multiple sclerosis.

Arterial and intracranial hypertension

When blood pressure elevations expressed patients complain of headache and dizziness. With long-term experience of the disease at the same time it appears or worsens tinnitus. When the coordination tests in a patient having difficulty.

All this indicates the presence of a hypertensive crisis. Should differentiate with stroke. Roughly also seen an attack of increased intracranial pressure. Treatment is reduced to the relief of hypertension, AB further antigipertenzinayaya therapy chosen physician or cardiologist.

Neuropathy, tumor

When violations of metabolism suffers the peripheral nervous system. This is possible in diabetes, cancer, thyroid problems. One of the manifestations of neuropathy - dizziness, tinnitus.

Using patogenticheskoy therapy (metabolic products) leads to the regression of clinical symptoms and complaints. In the presence of tumors growing complaints. They are unilateral or bilateral, but asymmetric. Identify the tumor is possible only after a full examination of the spectrum.

Diagnosis of vestibular disorders

Primarily we need examination by a neurologist, ophthalmologist and Laura. To find it a violation of the vestibular apparatus, it is necessary to conduct specific caloric test. This has otolaryngologist. He can spend postural tests to determine lateralization of sound.

Instrumental methods of pay great attention to CT and MRI. When portability is better to use contrasting techniques.

Tablets in violation of the vestibular apparatus

First group of drugs is needed for the relief of acute attacks of vertigo, vomiting. Ie, symptomatic therapy. It is used metoclopramide, ondansetron. Sometimes it helps to atropine, scopolamine. Especially effective past anticholinesterases in Meniere's disease.

Histamine blockers also help to cope with the attack. Effect have only those drugs that can penetrate the blood-brain barrier. It meklozin diphenhydramine.

Typical useful antiemetics vomiting. This Ondansetron, Metoclopramide, Dromperidon. 2-3 days of their use is not recommended. For recovery and normalization of vestibular function used Betaserk, Vestibo and Nootropil and GABA. To strengthen the effect needed physiotherapy.

Treatment of folk remedies

Only in conjunction with the main course of treatment it makes sense. Therefore, before using folk recipe, it is best to consult a doctor. The use of ginger in the form of broth helps to cope with nausea and dizziness. To do this, ground ginger, add the mint and chamomile flowers.

It can be used as fennel and orange zest. 15 min after infusion in boiling water drink can take up to 3 times a day for 4 tsp

Known balm, which is prepared by mixing three infusions: propolis, clover and Dioscorea. After the mixture is prepared, it is left for 10 days in a dark place. Then, three times a day after meals for one spoon resulting balsam can be taken in the absence of allergic reactions.

Exercises with vestibular disorders

In the acute phase vestibulopathy sense this. But for a more rapid recovery of function of the vestibular analyzer to conduct physical therapy is necessary.

complex classes

Exercises are performed no more than 15 minutes several times a day. They can be done even while lying in bed. The tempo of the need to gradually build up.

1. To start using eye movements with a stationary head fixed. First pupils move horizontally and then vertically.
2. And then anti-clockwise makes the rotational movement of the eyeballs.
3. Tilt and swivel head first to be performed slowly so as not to provoke a recurrence of vertigo attacks.

First, the eye can be closed. Later exercises are done with eyes open, and at a faster pace. In this case, for the complexity of being moved from one hand to the ball, or shrug. The vestibular apparatus in violation of functions reduces the quality of life, up to the formation of permanent loss disability.

Vestibulopathy symptoms are diverse, they are important to pay attention, even when the cause is already known (hypertension). With the deterioration of flow vestibulopathy existing or new-onset symptoms, it is important to seek professional medical help.

Video of the vestibular apparatus

Exercises for the vestibular system: