Vestibular SIG

BPPV is a particular condition characterized by rotational vertigo lasting 10 to 25 seconds, triggered by a specific head position. The patient experiences brief rotational vertigo, exclusively triggered by changes in position: lying down, getting up from bed, turning over in bed, especially to one side, but also looking up or down. The etiology of this vertigo is benign. It is caused by a deposit of small calcified particles (otoliths) in the semicircular canals of the inner ear.

This vertigo is treated with a specific therapeutic maneuver called a "liberatory maneuver," performed by a specialist physician or a vestibular rehabilitation therapist.

is an acute event caused by unilateral vestibular deficit, often total and isolated, without hearing impairment. It is an acute inflammation of the vestibular nerve responsible for sudden, complete, unilateral, and (almost) isolated paralysis of vestibular function. Neuritis is characterized by severe rotational vertigo with vomiting followed by imbalance that disappears within a few weeks. It is of viral (occurring in epidemics) or vascular origin. The outcome is most often favorable, thanks to drug treatments and vestibular rehabilitation.

is a disease that evolves in crises over several years, classically associating the triad of vertigo, hearing loss, and ear ringing (tinnitus) on one side, to which is attached the sensation of ear fullness. Ménière's disease is due to hyperpressure, dilation, or distension of the membranous part of the inner ear.

Typically, the crisis begins with severe tinnitus associated with a sensation of ear fullness. Hypoacusis (hearing loss) appears, and very often the tinnitus changes, becoming more acute. Then, rotational vertigo occurs, constituting the most spectacular element of the crisis. It is often intense, accompanied by nausea and severe vomiting. The duration is very variable, from a quarter of an hour to an entire day.

This disease is treated with medications and is combined with vestibular rehabilitation performed by a vestibular rehabilitation therapist.

It is a benign tumor, a "schwannoma," that develops at the expense of the Schwann sheath of the vestibular nerve in the internal auditory canal from the Scarpa ganglion. This tumor grows very slowly.

Treatment is surgical and followed by vestibular and possibly cranial rehabilitation.

is most often due to ototoxic antibiotics such as aminoglycosides. It can also indicate central damage (sedative drugs, strokes...)

It indicates vestibular responses that are too high. It is generally bilateral and indicates central damage (multiple sclerosis, diffuse vascular damage, cerebellar damage, AIDS...)

Under this term, we group together subjects complaining of balance disorders without having any particular neurological or ENT history and having normal oto-neurological functional explorations.

• presbyvestibulopathy (aging of the vestibule: epithelium, vascularization, nerve, and otoliths)
• presbyataxia (aging of balance: vision, vestibule, proprioception, nerve centers, motor response)