University:
The University of British Columbia
Course:
MEDD 448 | Transition into Postgraduate Education and Practice
Academic year:

2024
Views:

246

Pages:

2
Author:

O. Touhami

‭ nderstanding Vestibular Syndrome: Anatomy, Symptoms, and Diagnostic‬ U ‭Signs‬ ‭Symptoms‬ ‭-‬ ‭All‬ ‭symptoms‬ ‭and‬ ‭signs‬ ‭resulting‬ ‭from‬ ‭an‬ ‭injury‬ ‭to‬ ‭the‬ ‭vestibular‬ ‭system. The latter includes three elements:‬ ‭o‬ e ‭ vestibule, receptor apparatus located, with the cochlea, in the labyrinth.‬ ‭The‬‭semicircular‬‭canals,‬‭three‬‭in‬‭number,‬‭contain‬‭an‬‭endolymphatic‬ ‭fluid,‬ ‭itself‬ ‭containing‬ ‭otoliths‬ ‭whose‬ ‭movement‬ ‭will‬‭stimulate‬‭the‬ ‭sensory cells, at the origin of the vestibular nerve.‬ ‭o‬ ‭The vestibular nerve travels with the cochlear nerve in the internal auditory‬ c‭ anal.‬ ‭ ‬ ‭The vestibular nuclei of the brain stem, in connection with the‬ o ‭cerebellar vermis, the cervical cord, the reticularis of the brain‬ ‭stem, the oculomotor nuclei and the cerebral cortex.‬ ‭-‬ ‭The vestibular apparatus has the function of maintaining the balance of the‬ ‭body axis and maintaining ocular stability during movement.‬ ‭-‬ ‭In the labyrinth and the internal auditory canal, the vestibular and cochlear‬ ‭structures have intimate anatomical relationships. So that during peripheral‬ ‭damage (labyrinth or cochleovestibular nerve), there will most often (but not‬ ‭always) be an association of cochlear and vestibular signs. Conversely, in‬ ‭central damage (nuclei and vestibular pathways), the damage is dissociated,‬ ‭with only vestibular signs (without cochlear signs).‬ ‭Dizziness‬ ‭-‬ ‭This is the main symptom of vestibular syndrome. It is defined by an illusion of‬ ‭movement of the subject in relation to surrounding objects or surrounding‬ ‭objects in relation to the subject.‬ ‭-‬‭It is typically a sensation of rotation (etymologically vertigo comes from the Latin‬ ‭verso, versare: to turn). But it can also be about different impressions:‬ ‭movement of the body in the vertical plane (“like in an elevator”) or instability,‬ ‭described as pitching (“like on a boat”). Patients sometimes only describe a‬ ‭feeling of “head spinning” without any real illusion of movement, but the‬ ‭notion of a trigger or aggravation by changes in position then takes on a‬ ‭certain diagnostic value.‬ ‭-‬ ‭During intense dizziness, there are accompanying vegetative signs:‬ ‭nausea, vomiting, pallor, sweating, slowing of the pulse. Intense vertigo is‬ ‭particularly painful and often distressing.‬ ‭Balance and walking disorders‬ ‭-‬ ‭An imbalance when walking can dominate the symptoms, with vertigo stricto‬ ‭sensu being in the background or absent. The patient can describe sideways‬ ‭lurches, always on the same side, when walking. It may also be just a simple‬ ‭instability.‬ -‭ ‬‭In intense dizziness, standing is impossible.‬ ‭Balance disorders.‬ ‭-‬ ‭When standing with feet together, there appears a slow lateral inclination‬ ‭of the body axis after a few seconds of occlusion of the eyes. This deviation‬ ‭always occurs in‬