We are all familiar with the five senses: vision, hearing, touch, taste, and smell. What you may not know is that the vestibular organs are now recognized as their own multi-sensory processing unit. Unless something malfunctions, this system has likely never crossed your mind. However, the vestibular system can be thought of as our sixth sense.

The vestibular organs are the semicircular canals and otoliths found in the inner ear. This complex system is what enables us to move through our day-to-day. It impacts our motor control, learning, and perception. 

It is the integration of vestibular, visual, and somatosensory/proprioceptive inputs that allows us to navigate our environment and interact with one another. It is not until someone experiences one of the many vestibular disorders in Raleigh, NC, that they start to think about this system.

What Are Vestibular Disorders?

Many doctors do not study this system, but rather specializes in one part of the system. This is why people often have a hard time recovering from a vestibular issue. At the Carolina Brain Center, our integrative approach sets us apart from the rest. When you experience issues such as vertigo, unsteadiness, or dizziness, our neurologist in Raleigh, NC, will evaluate the vestibular system to determine the root cause of your concerns.

Vertigo

Vertigo is a spinning sensation caused by a problem in the inner ear, a nerve pathway, or in the brain. The most common cause of vertigo is BPPV, a condition where the crystals in the ear become dislodged and move into one of the semicircular canals. The vertigo is associated with certain changes in the position of the head.

Treatment for vertigo depends on what is causing it. If BPPV is the cause, a canalith repositioning maneuver, such as The Epley Maneuver, can be performed. Each repositioning maneuver is specific to whichever semicircular canal the crystal moved into. For all other causes of vertigo, the treatment will be specific for the cause.

Unsteadiness & Dizziness

There are a number of reasons people begin to feel unsteady on their feet. For instance, neurodegenerative diseases like Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, and ALS, can all cause a feeling of unsteadiness. Lower back issues can also cause someone to feel unsteady on their feet. Unsteadiness is very common to concussions and usually involves both the visual and vestibular systems - specifically how they are working together.

Feeling dizzy, or fainting when you stand up can result from either an inner ear issue or a vascular issue. Children going through a growth spurt may also experience this for a short period of time. Dizziness due to a vascular issue is ultimately a problem with the autonomic nervous system (ANS). The ANS is responsible for all the things going on in your body that you do not have to regular consciously, such as your heart rate, breathing, and blood pressure.

People with postural orthostatic tachycardia (POTS) will often feel dizzy or faint when they stand up. Taking blood pressure while a person is lying down, sitting up, and standing in sequence is a good way to assess the body’s efficiency for maintaining blood pressure. If blood pressure drops sharply when sitting or standing, the heart rate will become rapid and the person will feel faint.

Other Vestibular Issues

If you experience a problem with the vestibular-ocular reflex (VOR), it can result in the feeling of imbalance. When your head moves in one direction, your eyes move in the opposite way. The VOR stabilizes images on the retina during head motion so there is no retinal slip. If a slip occurs, it can create an intense feeling that your body or your surroundings are moving. While it is important for the VOR to work properly, you also need the ability to cancel the reflex. That way, if something is moving quickly, you can move your head and eyes at the same time to follow.

An issue with the vestibular organs can create feelings of dizziness, vertigo, nausea, motion sickness, the inability to walk without dizziness, and not feeling grounded. The semicircular canals in our ears give us our sense of rotational movements, like spinning left to right or tumbling back and forth. The otoliths are what gives us our sense of linear, or translational movement. Picture yourself standing on a moving sidewalk, facing whichever direction you choose. If you closed your eyes, you should be able to tell which way you are traveling.

Problems with the cerebellum or in the reciprocal connections between the vestibular nuclei and the cerebellum can also result in a variety of symptoms. Your postural control, for example, is preprogrammed muscle activation patterns that allow a person to maintain balance. We can see the breakdown of these patterns in the elderly and after concussions. Childhood developmental disorders can cause these patterns to not develop correctly, resulting in struggles with motor control.

Treating the Vestibular System

When it comes to treating the vestibular system in Raleigh, NC, there is no cookie-cutter answer. It is the link between the sensory and motor systems and is directly involved in higher brain functions, such as spatial orientation, motion perception, and path finding. That is why a thorough neurological examination from the Carolina Brain Center is so important. Our neurologist will incorporate visual and vestibular tasks to ensure the most accurate diagnosis and treatment. 

Concussions, neurodegenerative diseases, viruses, Lyme disease, PTSD, and some childhood developmental disorders can all result in feelings of imbalance. If you are suffering from any of these conditions, or suspect that you may be, request a consultation today.

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