vestibular dysfunction
Introduction
Introduction to vestibular dysfunction Vestibular dysfunction refers to the imbalance of vestibular function, including vestibular dysfunction or loss and vestibular hyperactivity. The vestibule is the main peripheral receptor of the human body balance system. It is one of the inner ear organs. It is located inside the sacral rock and is closely connected with the semicircular canal and cochlea to form the inner ear bone. In daily life, the human body mainly relies on the peripheral receptors of the three systems of vestibular, visual and proprioception to sense the position, movement, and external stimuli. The balance center information is integrated and coordinated to maintain the body in a suitable space. In terms of maintaining balance, the frontcourt system of the above three systems is the most important. The vestibular receptor includes three semicircular canals, an elliptical sac and a balloon. The three semicircular canals of the vestibule sense the angular acceleration of the body's rotation. The elliptical sac and the balloon, also known as the otolith, are mainly used to sense the stimulation of linear acceleration motion. For example, sitting in a moving car, even if you do not look out the window, you can sense the acceleration, deceleration or turning of the car through the vestibule, thereby generating eyeball, neck muscle, limbs and trunk muscle reflexes to adjust the posture to maintain balance. The role of the vestibular system is more important than vision. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: dizziness, edema in children, ear vertigo syndrome, motion sickness, positional vertigo
Cause
Cause of vestibular dysfunction
First, organic lesions:
Vestibular dysfunction refers to the imbalance of vestibular function, including vestibular dysfunction or loss and vestibular hyperactivity. Low vestibular function can be common in the following diseases:
1, vestibular peripheral vertigo
(1) Cochlear vestibular disorders include: 1 in the labyrinth: such as sudden deafness, Meniere's disease. 2 lost inside and outside: such as aminoglycoside ototoxicity.
(2) vestibular disorders include: 1 lost: such as benign paroxysmal positional vertigo, motion sickness. 2 lost: such as vestibular neuron inflammation.
2, vestibular central vertigo
Includes: 1 vascular. 2 tumor, trauma, degenerative diseases.
The causes include: viral infection, inner ear circulatory disorder, autoimmune disease, trauma, tumor, ototoxic drugs, congenital factors.
Second, other internal and external factors stimulate:
The vestibular dysfunction is not necessarily an organic lesion. It even includes hypersensitivity of the vestibular organs, vertigo and dizziness caused by excessive stimulation of the vestibule of the inner ear. The most common is motion sickness, which has certain genetic factors. In addition, emotional stress, anxiety, lack of sleep or smell of bad odor are also predisposing factors.
Prevention
Vestibular dysfunction prevention
1. Actively exercise, participate in outdoor activities, improve your own immunity, prevent disease invasion and avoid viral infections such as colds.
2, pay attention to avoid the impact of trauma, tumors, ototoxic drugs, congenital factors.
3, to avoid irritating foods and tobacco and alcohol, food should be less salt, seizures should not go out alone in order to prevent accidents.
Complication
Vestibular dysfunction complications Complications, dizziness, vaginal edema in children - ear vertigo syndrome, motion sickness, positional vertigo
There will be dizziness and dizziness during the acute attack. At this time, avoid strenuous activities and irritation to prevent trauma such as falls.
Symptom
Vestibular dysfunction Symptoms Common symptoms Rotating vertigo nausea and vomiting balance dysfunction Tinnitus Cochlear deafness Dizziness-like dizziness Dizziness Tinnitus Blood pressure High heart rate Increased sweat
Dizziness and dizziness are the most common manifestations of vestibular dysfunction, with the following forms:
1. Motion illusion vertigo
Rotational vertigo, linear vertigo or displaced vertigo: sudden vertigo as the main manifestation in acute attacks, true vertigo, patients with self-inducted foreign objects moving or self-moving, accompanied by nausea, vomiting, diarrhea, individual patients appear Chest tightness, sweating, yawning, increased heart rate, high blood pressure.
2, balance imbalance, imbalance
It is characterized by posture and gait balance disorder. When the patient stands or walks, he leans or tilts to one side, feels unstable, and feels awkward or stunned while walking.
3, dizziness, dizziness
Patients often cannot express their discomfort, such as dizziness, top-heavy feet, numbness in the head, emptiness, head tightness, heavy head pressure, black eyes and so on.
4, other
Can also be accompanied by the performance of the primary disease, such as deafness, tinnitus and so on.
Examine
Examination of vestibular dysfunction
1. Eyeball tremor
Eye movement is an involuntary rhythmic movement of the eye. Vestibular nystagmus consists of alternating slow and fast phase movements. The slow phase is the slow movement of the eyeball in a certain direction, which is caused by the vestibular stimulation; the fast phase is the rapid return movement of the eyeball, which is the central corrective movement. The slow phase of the eye movement is toward the side of the vestibular excitability, and the fast phase is toward the side of the vestibular excitability. Since the fast phase is easy to observe, the direction indicated by the fast phase is usually used as the direction of the nystagmus.
2, vestibular eye movement examination method: mainly refers to semi-regulatory tube function check.
(1) Cold and heat test: The cold and heat test induces a vestibular reaction by injecting cold, warm water or air into the external auditory canal. According to the parameters of nystagmus, the slow phase angular velocity is mainly used to analyze the strength of the reaction, and the function of the semicircular canal is evaluated. 1 Spontaneous nystagmus first stimulates the ear of the slow phase of the nystagmus. Generally, the slow phase angular velocity is used as a parameter to evaluate the side semicircular canal tap and the dominant bias. 2 trace ice water test: 0.4ml of normal vestibular function can lead to horizontal nystagmus, direction to the opposite side.
(2) Rotation test: The rotation test is based on the following principle: the semicircular canal rotates in a certain direction on its plane. At the beginning, the lymph fluid in the tube is deflected by the inertia and the ampulla is reversed in the opposite direction of rotation; The lymph fluid is also deflected by the inertia, but the direction is opposite to that at the beginning.
(3) Shaking head test: The latent and vestibular-derived nystagmus induced by the sitting subject after shaking the head horizontally and horizontally for 10 to 15 seconds at a specific frequency.
(4) Taro test: also known as pulse pendulum test, when the unilateral vestibular function declines, the head moves to the affected side, and the rapid eye movement toward the healthy side appears immediately.
3, ear stone inspection
(1) Positional nystagmus examination
Positional nystagmus is an nystagmus that occurs when the patient's head is in a certain position. Displacement nystagmus is mainly used to diagnose benign paroxysmal positional vertigo. However, it can be identified by the characteristics of nystagmus such as latency, duration, fatigue, direction of nystagmus and the presence or absence of vertigo.
(2) vestibular evoked myoelectric potential
The myogenic potential recorded by the strong stimuli on the surface of the sternocleidomastoid muscle in tension is a means of examining the function of the balloon. VEMPs can be used to test the response to the vestibular-cervical reflex pathway. The subject's head is biased to one side and the sound is given on this side, ie the unilateral conduction characteristics of the VEMPs contribute to an objective assessment of the balloon function on the test side.
4, other
Audiological examination and vestibular function examination should be performed. If necessary, check the head MRI and other auxiliary diagnosis.
Diagnosis
Diagnosis and identification of vestibular dysfunction
diagnosis
In addition to the specific medical history and clinical manifestations, audiological examination and vestibular function examination should be performed. In order to find the cause, the head MRI and other examinations to assist diagnosis.
Differential diagnosis
Special attention should be paid to internal auditory examination to rule out other diagnostic possibilities, such as cerebellopontine angle tumors, brain stem hemorrhage or infarction.
