The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or occur for unknown reasons. One recent large epidemiological study estimates that as many as 35% of adults aged 40 years or older n the United States have experienced some form of vestibular dysfunction requiring physical therapy involving vestibular rehabilitation.
The vestibular system consists of 5 organs: 3 semicircular canals that are sensitive to angular accelerations (head rotations) and 2 otolith organs that are sensitive to linear (or straight-line) accelerations. Their unique arrangement allows them to detect specific head movements. The central nervous system integrates the information from the vestibular system to stabilize gaze during head motion by means of the vestibulo- ocular reflex (VOR) and to modulate muscle tone.
Common symptoms include chronic dizziness or imbalance, spinning or whirling sensation, lightheadedness or rocking sensation. These symptoms can be presents while sitting still, in specific positions or with movement, and can have significant impact on the ability of a person to perform activities of daily life.
A thorough physical examination will usually establish the diagnosis of vestibular disorders. The underlying cause of vestibular disorders will help direct treatment and plank of care. Most instances of vestibular disorders can be successfully treated conservatively (physical therapy, chiropractic, massage, etc.) with the Epley maneuver and VOR exercises.
1. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2009;169(10): 938-944.