Vestibular Disorders, Essay Example

Vestibular neuritis

This disease is brought about by a disparity of neuronal input between the inner ears, thus resulting to an acute episode of vertigo. It is primarily caused by a virus and damages the vestibular nerve which is responsible for transmitting messages about balance and movement between the brain and inner ear. The virus can often originate from the gastrointestinal or respiratory system (Herdman, 2007). Vestibular Neuritis can range anywhere from a single episode of vertigo to a series of paroxysmal attacks lasting up to six weeks (Drislane et. al., 2009). Antihistamines, antidopaminergic and anticholinergic medications can decrease the severity of vertigo but may not completely eliminate the symptom. Rehabilitation can be undertaken under the direction of a physical therapist, who will usually determine a series of exercises that focuses on regaining balance and elimination of dizziness.

Chiari Malformation
A Chiari malformation indicates displacement of the lower part of the brain towards the spinal cord. It has 3 types with a majority of patients having a Type 1 Chiari malformation, which is the least severe of the three types. Type 2 and Type 3 Chiari malformations are uncommon but has more serious implications (Rosenbaum & Ciaverella, 2004). People with Type 1 Chiari malformation develop symptoms quite late in their life while most remain asymptomatic. Symptoms include headaches, usually localized at the occipital part of the head, dizziness, numbness, neck pain, hearing loss, nystagmus, blurred vision and insomnia. Decompression surgery may be undertaken in order to alleviate the pressure at the base of the brain. Bone from the base of the skull is removed, thus allowing more space inside the foramen magnum.

Acoustic Neuroma

Also known as vestibular Schwannoma, it is a benign tumor that develops in the acoustic nerve. Since the acoustic nerve is largely responsible for hearing and balance, this disease causes problems in these areas such as tinnitus, vertigo and hearing loss (Ramnarine & Whitfield, 2005). An Acoustic Neuroma is rarely life threatening as they develop very slowly and do not tend to spread so it is most often monitored. However, treatment options include radiotherapy or surgery for tumor removal.

Central Vertigo
Central Vertigo is brought about by a disease that stem from the Central Nervous System which includes tumors, infection, and injury along with lesions of the 8^th cranial nerve. Symptoms associated with central vertigo are less intense compared to peripheral vertigo, have a gradual onset and is often accompanied by other neurologic symptoms such as slurring of speech or double vision (Karatas, 2008). Treatment of central vertigo is aimed at alleviating symptoms and includes medications such as antihistamines and benzodiazepines. In cases of

Mondini Syndrome

Mondini Syndrome is an abnormality of the inner ear with only 1.5 turns to the cochlea as opposed to a normal cochlea that has 2.5 turns. The disease is characterized by bilateral sensori-neural hearing loss although the ability to hear high frequency sounds is possible as that basal turn of the cochlea is undamaged. Treatment consist of application of a multi-channel cochlear implant to improve hearing (Bluestone et. al., 2003)

Labyrinthitis

This disease is an infection in the inner ear. The labyrinth is a structure found deep inside the ear, and houses the cochlea and the vestibular system. Either a viral or bacterial infection can cause the Labyrinth to become inflamed, thus affecting balance and hearing. Symptoms are generally mild such as dizziness, vertigo, hearing loss and loss balance but can last up to several weeks. Treatment comprise of rest and medications to alleviate the symptoms. In rare cases, the disease can persist for months and even years and individuals may have to undergo Vestibular rehabilitation therapy (Burton et. al., 2008)

Benign Positional Vertigos

Vertigo is most often caused by benign positional vertigo, wherein an individual suddenly develop a spinning sensation, particularly when moving the head. It is caused by an irritation inside the inner ear and diagnosis is confirmed through a Dix-Hallpike maneuver. Aside from a spinning sensation, other symptoms include nausea, loss of hearing, vomiting, balance problems and vision problems (Bhattacharyya et. al., 2008). Epley’s maneuver is the most effective treatment as it can mobilize the calcium deposit floating inside the inner ear.

References

Bhattacharyya, N. et al. (2008) Clinical practice guideline: benign paroxysmal positional vertigo, Otolaryngol Head Neck Surg 139 (5 Suppl 4): S47–81.

Bluestone, C.D et al. (2003) Pediatric Otolaryngology, W.B. Saunders Company.

Burton, M. J. et al. (2008) Extracts from the cochrane library: Vestibular rehabilitation for unilateral peripheral vestibular dysfunction (review). Otolaryngology – Head and Neck Surgery, 138(4), 415-417.

Drislane, F. et al. (2009) Neurology Blueprints, Philadelphia: Lippincott Williams & Wilkins. pp. 54

Herdman, S.J. (2007) Vestibular Rehabilitation, 3^rd Ed. Philadelphia: F.A. Davis Company

Karatas, M (2008) Central Vertigo and Dizziness, The Neurologist 14 (6): 355–364.

Ramnarine, D. & Whitfield, P. (2005) Management of patients with vestibular schwannoma. ACNR, 5(4) 2

Rosenbaum, R.B & Ciaverella, D.P (2004). Neurology in Clinical Practice. Butterworth Heinemann. pp. 2192–2193.