Structure and functions of vestibular mechanisms. Vestibular disorders: symptoms and treatment

Most people in the world know what the vestibular apparatus is. But, unfortunately, not everyone understands what a vital function it carries in itself. Such an irreplaceable part of our body is responsible for balance, coordination, orientation of the body in space, as well as partial work of vision, hearing and general sensitivity in the body. The structure of the organ is located in such a way that the main part of it is in the inner ear, but the main work still takes place in a specific part of the brain - the cerebellum.

The basis of the whole device- this is the concentration of ciliated cells in the inner ear, endolymph, as well as otoliths (specific calcareous formations) and jelly capsules in the ampullae of the semicircular canals.

human vestibular apparatus gives signals of two types: statistical (often they are associated with the position and coordination of the human body in space, finding its individual parts) and dynamic (movements associated with acceleration). The whole work looks like this: mechanical irritation of the hairs occurs, as a result of which a signal of a certain type enters the human brain, and after analysis, the brain gives the appropriate command to the muscles. And all this in a fraction of seconds. In other words, there is a coordination of human muscles, which makes it possible for the body to orient itself in space. If we make a rather rough comparison with human technology, then the gyroscope is the most suitable tool for this.

Vestibular disorders

Causes of violation of the vestibular apparatus is a malfunction of the cerebellum. Dysfunctions often appear if there are vascular, inflammatory diseases of the nose, ears or eyes (including disorders of the inner ear), trauma, Eustachian tube dysfunction, viruses and infections, as well as diseases of bacteriological etiology. As you know, the ear is not a hermetic organ, hence it follows that even if such a small part of everyday life as thorough hygiene is missing, vestibular disorders can occur. Therefore, special attention must be paid to water procedures and drying of the ear canal.

Problems and diseases of the vestibular apparatus

In other cases, it is impossible, at first glance, to determine the symptoms of a violation of the vestibular apparatus. The problem is not visible to the naked eye, appears only in certain situations or by conducting simple physical exercises, tests. A special risk group that is prone to various dysfunctions of an important organ is people over 60. This happens not only because at this age the risk of ENT diseases increases significantly, but also because of a general deterioration in immunity and wear and tear of the body.

Vestibular disorders of the apparatus can give out a symptom, or even symptoms, such as:

are present and psychosomatic phenomena, such as:

• panic;
• increased heart rate;
• increased heart rate;
• sweating of the hands;
• desire to hide in the far corner;
• violation of blood pressure;
• a sharp change in complexion (blanching, redness);
• increased salivation.

Man simply cannot control his brain. It seems to him that he is about to fall, he is terribly afraid of flying. The escalator causes panic horror. Symptoms often occur unexpectedly, characterized by both constant and erratic time intervals between manifestations of the disease.

Symptoms may appear for any of the following reasons:

1. Sharp aromas.
2. Motion sickness in any of the modes of transport.
3. Syndrome of vertebrobasilar insufficiency.
4. Increase in blood density.
5. Ear edema.
6. Head injuries, including craniocerebral.
7. Taking medications, including chemical or antibiotics.
8. body intoxication.
9. Vestibular neuritis.

And also the cause of violations of the vestibular apparatus can be acquired or congenital diseases of the cardiovascular, nervous system.

Diseases of the vestibular apparatus

Vestibular neuritis

The main syndrome found in a number of diseases of the vestibular apparatus. One of the most common causes of disorders of the vestibular apparatus is damage to the vestibular nerve. It can occur at any age, often the cause of the disease can be an infection of the nasal cavity, upper respiratory tract, as well as ears and throat.

Neuritis is accompanied by the following syndromes:

• dizziness;
• nausea, with possible repetitions.

Recovery of the organ responsible for balance occurs quickly and, in most cases, successfully.

Blockage of the internal labyrinthine arteries

The most dangerous dysfunction of the coordinating organ, characterized by an imbalance in the blood supply to the brain, which leads to a lack of nutrition, oxygen starvation, and in especially difficult cases, to cerebellar damage caused by a stroke or heart attack. The main symptom of the disease is dizziness. And also deafness (partial or complete), as well as loss of orientation in space, can be observed.

Meniere's disease.

The disease is often diagnosed by symptoms such as a scheduling or buzzing sound, infrequent dizziness, nausea, and in special cases, clouding of consciousness. Often the disease is bacterial, viral or infectious. The action itself takes place in the membranous labyrinth.

Benign positional vertigo

It occurs more often in the elderly, but can occur at any age. Most often, before such a disease, a person suffers from ear, nose, and throat diseases, but often the exact cause of the disease is unknown. Vertigo, comes on in short attacks, repeated every time there is a change in position of the body in space.

Vestibulopathy

The disease is characterized by many dysfunctions of the vestibular organ, the main and most frequent manifestation of which is the lack of coordination of a person in space. The disease can be considered both separately and in conjunction with other characteristic failures in the body. Treatment of vestibulopathy is complex and often has a favorable outcome, especially with early diagnosis of the disease.

Chronic bilateral vestibulopathy.

Vestibulopathy manifests itself as a slowly growing dysfunction of stability and moderate, but stable (when compared with partial) vertigo. Most often, the disease is associated with poisoning with ototoxic drugs.

Vertebral - basilar insufficiency

In old age, after displacement or any other movement of the head, there is a feeling of rotation or fluctuation in the eyes, nausea, infrequently, pain can radiate to the stomach. All these are symptoms of the disease. Not only the device itself is treated, but also the cardiovascular system. People with existing cardiovascular diseases who have had operations on the cardiovascular system often suffer from vertebrobasilar insufficiency.

post-traumatic dizziness

Occurs subsequently after traumatic brain injury, as well as concussion, and any other head injuries or fracture of the temporal bone.

Infectious and viral diseases of the ear

Diseases carry a direct threat to the vestibular apparatus simply because the risk of complications to a nearby organ is very high. Which directly affects the state.

Vestibular dysfunction

Occurs when the vestibular nuclei do not work properly. Most often, dysfunction is confused with a variety of ailments of the vestibular apparatus, simply because dizziness is the most common symptom. Subsequently, appeals to a specialist, most often the patient is provided with vestibular resuscitation.

Treatment and training of the vestibular apparatus

Often, many complications that can be associated with an organ-balance, can be improved by training. Treatment of disorders or even diseases depends on the severity and neglect of the situation. If you notice one or more of the symptoms of the disease, you should immediately consult a doctor. AT this case an otolaryngologist can help.

The specialist will help you understand the causes of your illness, conduct an examination and provide the necessary assistance. Additional tests will be assigned to you in order to rule out a misdiagnosis. After a detailed diagnosis, you will be assigned a unique therapy suitable only for your disease. Treatment of the vestibular apparatus is always complex, often requiring long-term rehabilitation after.

How to improve the vestibular apparatus?

Weak vestibular apparatus is not only possible, but also needs to be strengthened. For this, certain exercises are suitable, aimed at improving coordination and increasing the sensitivity of the body. A set of tasks aimed at the formation of strong muscles, an adequate analysis of nerve endings, as well as psychosomatic well-being was developed back in the distant 30s.

vestibular sensitivity the most ancient after the general types of sensitivity. The origin and formation of life on Earth took place under the conditions of the existence of two global factors of the geomagnetic field and gravity. The latter factor had an important influence on the formation of complex organisms due to the need to take into account the gravity vector to implement the antigravitational position of the body.

Functions of the vestibular apparatus

The vestibular apparatus is a sensory organ that perceives, with the help of vestibuloreceptors, changes in the position of the head and body in space, as well as the direction of movement. The vestibular apparatus ensures the balance of the body in a standing position, when walking, running, jumping, while dancing, when going up and down stairs, while swimming, when riding various types of transport, while performing gymnastic exercises, that is, with all movements, when the human body moves from the simplest position to the most complex, the vestibular analyzer (apparatus) appears. If the activity of this analyzer is disturbed, there is a decrease or complete loss of the ability to maintain the balance of the body in space.

The structure of the vestibular apparatus

Vestibulocochlear nerve

The vestibular apparatus has become the main channel signaling the body's position in space relative to the gravitational vector. Vestibular sensitivity is carried out by the vestibulocochlear nerve (VIII pair), which includes two types of reception - vestibular and auditory. The principle of organization is the same as that of the general types of sensitivity, namely: the peripheral part (the receptor neuron with its node and root of the vestibulocochlear nerve) and the central part (in this case, the auditory and vestibular nuclei are homologues of the posterior horns of the spinal cord).

Violation of the functions of the organ of balance occurs as a result of various diseases, injuries and due to the lack of training of this organ from an early age. When accelerating human movements, during rotational, oscillatory movements, while driving, the hypersensitivity of these receptors causes a strong excitation of their nerve centers, which are located in the pons. As a result, dizziness, flashing in the eyes, palpitations may appear, a decrease in blood pressure, blanching of the face, nausea, vomiting, sometimes even fainting can be observed.

With severe damage to this analyzer, a person’s head is spinning even when getting out of bed, “flies” appear before his eyes and nausea, and he is forced to quickly sit down or lie down. With mild injuries to the vestibular analyzer, it is difficult for a person to maintain balance and he feels awkward when performing complex movements - when running fast, jumping, circling, when going up and down stairs, etc. Consequently, the main complaint of patients with damage to the vestibular apparatus is dizziness, usually accompanied by ataxia.material from the site

Irritation of the vestibular apparatus causes nystagmus in the direction of the lesion, and its inhibition - in the unaffected side. If necessary, conduct caloric and rotational tests. A caloric test - the infusion of cold (about 20 ° C) water alternately into both ears of a patient - causes horizontal nystagmus in the opposite direction in a healthy person for up to 1 minute. When the vestibular apparatus is damaged, caloric nystagmus drops out or, conversely, intensifies.

A rotational test is performed while the patient is in a special chair. After ten revolutions, the chair is stopped, while the subject develops nystagmus in the direction opposite to rotation, lasting 15-25 s. With damage to the vestibular apparatus, rotational nystagmus falls out or, conversely, increases.

Everyone is familiar with such a concept as the vestibular apparatus, but not everyone knows what it is, where it is located and what it is responsible for.

The vestibular apparatus is one of the departments of the system that regulates the balance of a person and is responsible for his orientation in space. When the work of the vestibular apparatus is disturbed, problems with vision and hearing appear - a person begins to lose spatial orientation, sensitivity.

Signs of problems with the vestibular apparatus

• Dizziness
• Feeling of nausea, vomiting
• Paleness or redness of the face
• Violation of motor coordination and balance
• Profuse perspiration

Typically, these signs of violations are intermittent - they appear periodically: with a sharp sound or smell, a sudden change in weather or travel in transport. The rest of the time, the person does not feel the presence of a problem.

There are many reasons for the problems. Some of these are directly related to inner ear infections.

Causes of problems with the vestibular apparatus

Positional vertigo. This problem is especially common in women over the age of sixty, sometimes in men of the same age. Symptoms of this problem are: the appearance of a sensation of rotation in a circle when the posture of the head changes, a feeling of nausea, vomiting, and sometimes a sharp stomach pain.

• Vestibular neuritis. Usually happens due to infections, lichen. One of the most common problems of the vestibular apparatus. Vestibular neuritis can be judged by the following symptoms: dizziness with the illusion of rotation in a circle, nausea, vomiting.

Usually, symptoms of particular severity last for three to four days, after which they disappear, but full recovery should not be expected until a month later. In older people, this condition can last for a couple of months.

• Symptom of vertebrobasilar insufficiency. Violation of the vestibular apparatus manifests itself in conjunction with diseases of the cardiovascular system. It is especially common in people who have reached the age of sixty. Deficiency may appear after a stroke, problems of the organs of the inner ear, vestibular nerve. There is nausea, vomiting, balance is disturbed, because of which a person constantly falls, and coordination and visual perception do not work correctly - the image often bifurcates. Speech becomes incoherent.

The syndrome described above is short-term, and if the symptoms of the disease continue to appear for a long time, the patient should be admitted to the hospital for a more detailed examination and identification of all problems.

• Blockage of the internal auditory artery. This problem is very dangerous, occurs in conjunction with impaired blood supply to the brain, which can lead to cerebellar stroke, heart attack. An acute degree of dizziness, loss of coordination and balance, one-sided deafness - these are the main signs of fatal and dangerous disorders of the vestibular apparatus. If symptoms are detected in a patient, an ambulance should be called urgently.
• Bilateral chronic vestibulopathy. Appears due to drug intoxication. Moderate dizziness, nausea, impaired stability appear.

• Manier's syndrome is one of the most common inner ear problems. In the presence of this syndrome, dizziness increases quickly, and subsides much more slowly, hearing decreases at different intervals, which, in the end, can lead to complete deafness, as well as a feeling of noise in the ear and congestion.
• Ear diseases: otosclerosis (damage to the bone capsule of the inner ear), sulfur plug, dysfunction of the auditory tube. Appears otitis media in acute form or purulent otitis media.
• Various types of injuries
• Basilar migraine. Signs are the appearance of prolonged dizziness that occurs with seizures, the problem is especially common among teenage girls - they are more prone to motion sickness in transport.
• Epilepsy. Dizziness, nausea, impaired consciousness and hallucinations are the main signs of the onset of disorders.

• Tumor of the cerebellopontine angle. Hearing decreases gradually, which can eventually lead to its complete loss. Dizziness is not typical for this type of tumor, but there is a violation of coordination of movement.
• Craniovertebral pathology. Almost the most common cause of violations of the vestibular apparatus, accompanied by speech and swallowing disorders.
• Multiple sclerosis. It is accompanied by dizziness of a special degree and nausea.

Before starting to treat the organs of the vestibular apparatus, it is necessary to identify all the causes of the pathology.

Treatment of the vestibular apparatus and its strengthening

Feeling stable on your feet is one of the keys to a person's confidence. Man learned to stand straight and keep his balance hundreds of millions of years ago, when a new kind of man appeared - Homo erectus.

A person begins to lose balance when rolling on a ship or while traveling by transport, when trying to get out of bed abruptly or make sudden head movements.

The confident gait of a person directly depends on his vision - as soon as a person closes his eyes, his gait and movements become uncertain and shaky, he is forced to look for supports - to hold on to walls and protruding objects.

One of the ways to determine the cause of a violation of the vestibular apparatus is to carry out posturography - a graphic registration of the center of gravity of a person in a resting position and in the presence of various loads. The patient, with his eyes closed, stands on a rotating platform. At this point, his reaction is being studied. The slightest deviation from the norm is instantly fixed by the computer, after which the result is analyzed by specialists.

It often happens that a disease detected with the help of posturography entailed various types of consequences that persist even after exposure to an external stimulus.

A person needs to adapt to the disorders that have appeared and try to somehow compensate for all violations of the body.

The main method of rehabilitation and adaptation of the vestibular apparatus is a special vestibular gymnastics, which consists of specially selected exercises for training the vestibular system.

All gymnastics exercises are adjusted to the individual characteristics of each organism. A person performs exercises aimed primarily at training the vestibular apparatus.

• One of the best remedies for dizziness caused by problems with the vestibular apparatus is ginger. Four teaspoons of ginger should be mixed with a pinch of mint, fennel, and finely chopped pumpkin seeds, chamomile flowers, celery, and orange peel. Mix all herbs thoroughly and pour boiled hot water. Let the decoction brew for fifteen minutes, then take it inside. If the dizziness does not go away for a long time, it is best to consult a specialist.

• There is a balm that can help with violations of the vestibular apparatus. To prepare it, it is worth preparing three tinctures and mixing them.
• First tincture. It is necessary to fill with alcohol (about half a liter) clover flowers (forty grams). Let it brew for two weeks in a dark place.
• Second tincture. Anger with forty percent alcohol (half a liter) the roots of Dioscorea (fifty grams). Let it brew for two weeks.
• Third tincture. Cover soft pieces of propolis with seventy percent alcohol. Let it brew for 10 days in a place where the sun's rays do not fall, then carefully strain.

Combine all three tinctures with each other, take every day three times a day, after meals. The recommended amount is one tablespoon.

• Special exercises. Perform for fifteen minutes, preferably twice a day. You should start with a fairly slow pace, and then gradually increase it to the most suitable pace.
• Exercise number one. Without moving your head, move your gaze from bottom to top, then from left to right. Repeat twenty times in each direction, gradually accelerate the pace of movements.
• Exercise number two. Tilts forward-backward, left-right. Make twenty inclinations in each direction, gradually moving to the exercise with your eyes closed.
• Exercise number three. Sit on a chair or sofa and start shrugging your shoulders, then spread them in different directions in turn.
• Exercise number four. Toss a small rubber ball from one hand to the other for about one minute. You need to throw it above eye level. After a minute has passed, raise one leg and repeat the exercise, throwing the ball under the knee.
• Exercise number five. The task is very simple: you need to move to the room without closing your eyes. After a while, repeat the exercise, but with your eyes closed. If, after completing the task, there are no symptoms of a violation of the vestibular apparatus, you can start climbing and descending a small obstacle, also closing your eyes first.

The vestibular apparatus is the receptor section of the vestibular analyzer, located in. Thanks to special cells, the vestibular apparatus determines the position of the body in space, fixes its changes.

The structure of the vestibular apparatus

The receptor apparatus of the organ of balance is located in the thickness of the pyramid of the temporal bone. It combines the membranous semicircular canals and the sacs of the vestibule.

The membranous canals are located inside the bony canals. At the same time, they are smaller in diameter, but completely repeat all the bends of the bony semicircular canals and are attached to their walls by connective tissue strands, inside which the feeding vessels pass.

As a result of this structure, a small space is formed between the bony and membranous parts of the semicircular canals, which is filled by the perilymph, and inside them is the endolymph. These two fluids have a different electrolyte and biochemical composition, but are closely related to each other in a functional sense. They are located not only in the semicircular canals, but also in other parts of the ear labyrinth (cochlea, vestibule) and represent a kind of humoral system.

The bony semicircular canals are part of the bony labyrinth of the inner ear. In the human body, there are three such channels on the right and left sides:

• outer,
• front,
• rear.

According to their orientation in space, the external semicircular canal can be called horizontal (since it is located in the horizontal plane), the anterior canal is frontal, and the posterior canal is sagittal.

The membranous semicircular canals are internally lined with endothelium, with the exception of the ampullae, which contain sensory cells. It is in the ampullae of these channels that there is a rounded protrusion (comb), consisting of supporting and sensitive hair cells. The latter are the end of the peripheral fibers of the vestibular ganglion. The long hairs of these cells are interconnected in the form of a brush, the mechanical irritation of which, due to endolymph vibrations, is fixed by sensitive cells, converted into an electrical impulse and transmitted to the central nervous system.

In the central part of the labyrinth (the bony vestibule) there are two membranous sacs - spherical and epileptic, interconnected by a thin endolymphatic duct. In these anatomical formations, otolith apparatuses are laid in the form of elevations on the inner surface of the sacs, which also consist of supporting and sensitive cells. The hairs of the latter are intertwined with each other, forming a network, and are immersed in a jelly-like mass in which the a large number of otoliths (crystals of calcium carbonate and phosphate). With mechanical stimulation, the otoliths exert pressure on the hair cells, which contributes to the formation of electrical impulses.

Thus, the vestibular receptor apparatus consists of five sensory zones, located one at a time in the sacs of the vestibule and the semicircular canals. Peripheral fibers of the vestibular nerve ganglion, which is part of the vestibular analyzer, are suitable for each of these areas. For a better understanding of the functioning of the balance organ, consider the structure of the latter.

The structure of the vestibular analyzer

The vestibular analyzer consists of a peripheral (actually receptor apparatus) and a central section. Its important part is the vestibular ganglion, located in the internal auditory canal, the peripheral processes of which are suitable for sensitive hair cells, and the central ones are part of the vestibular part of the 8th pair of cranial nerves (vestibulocochlear). It is through these fibers that electrical impulses from receptors enter the medulla oblongata and the central nervous system.

The central department of the organ of balance is located in the temporal lobe of the brain. On the way to it, sensory fibers approach a group of nuclei in the medulla oblongata, which enable the vestibular analyzer to form many associative connections. This is the reason for its wide adaptive abilities. The main ones are:

• vestibulospinal,
• cerebellar, oculomotor,
• vegetative,
• cortical.

Such connections cause the development of certain reflex reactions, we will consider them below.

Functions of the vestibular analyzer

The role of the vestibular analyzer is not only to determine the position of the body in space and register its changes, but also to correct them. Adequate stimuli for vestibular receptors are various types of acceleration.

So, angular accelerations are perceived by the sensory cells of the semicircular canals, all types of rectilinear accelerations and vibrational stimuli fix the sensitive cells of the vestibule sacs. In response to mechanical stimuli of this type, various vestibular reactions arise due to the associative connections of the nuclei of the medulla oblongata.

1. Vestibulosomatic (associated with the presence of spinal connections; provide a redistribution of muscle fiber tone).
2. Oculomotor (contribute to the occurrence of nystagmus in the presence of vestibulo-oculomotor connections).
3. Vestibulo-vegetative (changes in blood pressure, heart rate, nausea, vomiting).
4. Vestibulocerebellar (contribute to the redistribution of muscle tone in motion; aimed at maintaining a certain position of the human body in space).
5. Central correction of vestibular reactions (due to connections with the cerebral cortex).

All these reactions are necessary for the body to maintain balance and body position in space, as well as to adapt to changing environmental conditions.

Conclusion

The vestibular analyzer has a rather complex structure, which ensures its normal functioning. The appearance of failures in its work at any level leads to the occurrence of pathological symptoms and the development of the disease.

Neurologist A. Medvedeva says about the vestibular apparatus:

Medfilm "Organ of balance":

People are moving all the time. Someone does it gracefully, someone clumsily, but any person needs to correctly assess his position in space every moment in order to be able to make the next movement. This assessment is made by the vestibular apparatus - part of the inner ear. For reliability, we have two ears and an apparatus.

The vestibular apparatus is a system of three semicircular canals that evaluates the acceleration that occurs when tilting, turning, or some more complex movement of the head. The operation of this entire system is based on fluid pressure on an elastic membrane. Not the most obvious, but understandable association is a tube filled with water, which is sealed on one side, and on the other side a balloon is pulled over it. If such a tube is tilted up and down, the ball will vibrate periodically.

The constituent parts of the vestibular apparatus are the three semicircular canals, which respond to tilts and turns of the head, and the otolith organ, which responds to acceleration during linear movement.

The semicircular canals are closed and filled with a viscous fluid. At the base of each channel there is a thickening, inside of which there is a cupula - this is such a jelly-like cap. He acts as an oscillating ball on a tube with water. Under the cupula are receptor cells. During the tilt of the head or the whole body in one direction or another, the liquid either presses on the cupula, or does not. The change in the position of the cupula is transmitted to the cilia of receptor cells, which, in turn, transmit this information along the nerves to the brain.

Crayfish also have a vestibular apparatus, but in order for it to work, it must have grains of sand from the river bottom. If you take out these grains of sand from the crab and replace them with iron filings (this can be done when the crab is shedding), and then bring a magnet to the crab, it will think that the bottom is where the magnet is.

The channels are in approximately perpendicular planes, which allows it to respond to tilts in all directions. Since there are two sets of semicircular canals in each head, we can get even more precise information about the position of the head: if the head turns to the right, the receptors in the right horizontal semicircular canal are stimulated, while the receptors in the left horizontal canal are inhibited, and vice versa.

Otolith organs consist of two sacs: round and oval. These sacs are also filled with a viscous fluid, and they also have ciliated receptor cells. Above the cells is a gel-like layer with small but rather heavy calcium carbonate crystals - otoliths. When accelerating in one direction or another, the crystals are displaced and stimulate the cilia of the receptors. Otoliths allow us to feel which is up and which is down.

Why do people get sick

Motion sickness can occur when the vestibular apparatus is overstimulated and the cupula with otoliths continually tug on the cilia of the receptor cells. This sets off a cascade of reactions in the brain, which, among other things, affects the vomiting center. The vestibular apparatus can be trained - and any sport will do here, except for chess - there will be less motion sickness.

But alcohol intoxication does not affect the vestibular apparatus. An unsteady gait is the result of the breakdown products of alcohol affecting the cerebellum, which is responsible for maintaining balance.