Not All Vestibular Dizziness is from the Inner Ear

Problems Can Result from Central Vestibular Connections Within the Brain

The ears are for more than just hearing.  There is what’s called a vestibular apparatus in the inner ear that is for sensing our head positions and movements.  While problems with this part of the inner ear is a common source of dizziness, sometimes the vestibular problem is not because of the ear(s) at all but rather the central vestibular connections within the brain.

Inner Ear Information Sent to Processing Centers in the Brain in a Fraction of a Second

The vestibular part of the inner ear is just one piece of a whole vestibular system, and problems anywhere along the nerve pathways in this system can cause dizziness or balance problems.  Here’s how the system works:  The inner ears send their information about head movement/position in along nerves to the main vestibular processing centers in the brain called the vestibular nuclei.  With help from other parts of the brain, in particular the coordination center or cerebellum, the vestibular nuclei weigh out the information from the ears against each other, as well as against what your eyes are seeing and your body is feeling, in order to be really sure about what body position or movement is going on.  Once it has that figured out, the nuclei send instructions:

1. up to your eye muscles to tell the eyes how to move so that we can keep things in focus while the head is moving, and 
2. down your spinal cord to all the muscles that need to fire in order to keep us upright and balanced.

This all happens in a fraction of a second!  The vestibular reflexes are among the fastest in the body since, as you can imagine, being able to see clearly when moving and keeping one’s balance are so important for function and survival. 

The Vestibular System Involves Many Nerve Pathways & Many Parts of the Brain and Body

So as you can see, the vestibular system is a very complex one, involving many nerve pathways and many parts of the brain and body.  That being the case, there are lots of potential trouble spots that have nothing to do with the inner ears but are still vestibular-related.   The inner ear is the most common culprit when it comes to vestibular dizziness, however, some conditions that can affect the central vestibular pathways and connections within the brain include:

• Migraine
• Tumors
• Head Injury
• Multiple Sclerosis
• Vestibular Epilepsy
• Stroke
• Age or disease-related degeneration of brain tissue
• Or anything impairing the supply of blood, oxygen or glucose to parts of the brain

While we can often make some positive changes with Vestibular Rehabilitation for people with central (brain-related) vestibular problems, it often takes longer, and the outcomes are not as good as when the problem is with the inner ear.  However, people with only central vestibular issues have better outcomes than those with both central and ear-related problems.

Contact us at http://www.lifemarkvestibular.ca - we can help!