Vestibular Ataxia: Causes, Symptoms, Treatment Tactics

The vestibular analyzer in the human body plays a leading role in maintaining equilibrium and is one of the elements of the statokinetic system. The statokinetic system is a combination of the sensitive sphere, the organ of vision, the cortex of the brain, the cerebellum, the vestibular apparatus, and the dorsal brain, and also other organs that ensures the maintenance of posture and balance during movement and at rest, purposeful movements, orientation in space. The impact of adverse factors on any organ of this system can lead to disruption of coordination of movements, loss of balance.

Vestibular ataxia is a violation of coordination of movements and maintaining a posture when a vestibular analyzer is damaged.

Causes

Hair cells located in the semicircular canals of the inner ear collect information about the position of the body in space, transform it into a nerve impulse, which is then transmitted along the vestibular nerve to the brain.

The vestibular analyzer is divided into the peripheral part (the labyrinth of the inner ear and the vestibular nerve) and the central part (the cortex of the brain).

Information on the position of the body in space, slopes, accelerations, gravity force is collected by the vestibular receptors (hair cells), which are located in the semicircular canals of the inner ear. From the receptors, impulses along the vestibular nerve are directed to the vestibular nuclei of the medulla oblongata, where information is sorted and the subsequent transfer of it to other structures of the central nervous system (cerebellum, cerebral cortex, spinal cord and others). It is generally believed that the labyrinth of the inner ear and the vestibular nerve represent the peripheral part of the vestibular analyzer, and the nerve pathways and nuclei, which lie beyond the medulla oblongata - the central section.

The interconnection of the various departments of the nervous system with each other ensures an agreed redistribution of muscle tone to maintain balance, adequate reduction and relaxation of the muscles for the reproduction of the motor act.

There are two main groups of causes that can cause vestibular ataxia:

1. Causes that lead to damage to the peripheral vestibular apparatus.

• BPHP (benign paroxysmal positional vertigo).
• Ménière's disease.
• Inflammation of the vestibular nerve (vestibular neuronitis).
• Injuries of the inner ear.
• Inflammatory diseases of the inner ear.

From this group of causes, inflammatory processes in the inner ear that lead to damage to the receptor apparatus and impairment of transfer of impulses to the overlying structures are most often encountered. In second place, the cause is DPPH and Meniere's disease.

1. The causes that lead to the defeat of the central part of the vestibular apparatus (brain stem).

• Multiple sclerosis.
• Stroke and vascular disorders.
• Other causes (neoplasms, craniocerebral trauma, encephalitis).

Damage to the vestibular nuclei of the central part of the analyzer occurs more often due to direct damaging the effects of craniocerebral trauma or on the background of a violation of the blood supply, which caused brain trauma.

Symptoms

When the vestibular apparatus is disturbed, as a rule, a triad of symptoms is revealed:

1. Systemic dizziness.
2. Nystagmus.
3. Violation of coordination of movements, which is designated by the term "ataxia".

Systemic dizziness is the leading symptom of vestibular ataxia. It is manifested by the sensation of the rotation of one's own body or surrounding objects around a person. Dizziness is often accompanied by a feeling of nausea or vomiting, which is amplified by changing the position of the head or closing the eyes. There is a false sense of displacement of the body in space. People with system dizziness tend to turn their torso and head in space less, as this strengthens the symptoms.

The lesion of the vestibular analyzer is often one-sided, so when moving, the body deflection always occurs in one direction. In a sitting or standing position, the symptoms do not disappear. The gait is broken, it becomes shaky (atactic), accompanied by falls.

They detect the vibrational movements of the eyeballs (nystagmus). Nystagmus can be of different amplitude: fine, medium or large-scale, but more often reveal fine-grained horizontal movements of eyeballs. The direction of the nystagmus is opposite to that of the localization site.

Often in such patients, heart rate increases, skin blanching, increased sweating.

Therapeutic tactics

First of all, it is important to eliminate the disease that caused the vestibular ataxia.

Therapeutic measures are selected individually in each case, taking into account the cause, which caused vestibular ataxia.

1. Etiotropic therapy is aimed at the maximum elimination of the cause of vestibular ataxia (anti-inflammatory therapy, antibacterial, elimination of consequences of craniocerebral injuries, surgical treatment, etc.).
2. Symptomatic therapy is used to improve the metabolism of nerve cells, increase resistance to adverse factors, which can reduce ataxia.

• Appointed courses nootropics (piracetam, cerebrolysin).
• Correctors of microcirculation (ginkgo biloba, actovegin, etc.).
• Vitamins of group B (neurobion).

1. Special complex LFK is aimed at training the coordination of movements, strengthening the muscular framework. The complex is selected by the trainer individually.

The combination of drug therapy and exercise therapy is aimed at reducing the symptoms of imbalance, reducing dizziness.

Self-treatment of vestibular ataxia does not lead to recovery.

A competent examination by a specialist can identify the cause of the disease and develop effective treatment tactics. It should be noted that it is not always possible to achieve recovery of the patient, more often it depends on the cause of the disease and the stage of the pathological process.