Vestibular ataxia is damage to any part of the vestibular apparatus, causing disruption of its work: poor coordination of movements, inability to quickly change or simply take certain poses, instability in sitting and standing positions, as well as during walking.
The content of the article:
Causes of vestibular ataxia
Signs of vestibular ataxia
Diagnosis of vestibular ataxia
Treatment of vestibular ataxia
Prevention of vestibular ataxia
Vestibular ataxia
Causes of vestibular ataxia
The most common cause of the occurrence and progression of this disease is inflammation of the inner ear. As a result, the vestibular apparatus, namely its hair cells, are damaged. The lesion of these tissues may appear after receiving an ear injury or due to the spread of infection in the acute form of otitis media of the middle ear. Degeneration of hair cells can lead to the growth of an ear tumor or toxic poisoning of the body by secretions of cholesteatoma inside the ear.
Sometimes the disease occurs when the vestibular nerve is damaged as a result of the development of tumors, infections or poisoning with toxins. In rare cases, ataxia manifests itself as a complication after viral diseases: herpes, influenza, SARS and others. Often ataxia becomes a consequence of damage to the vestibular nuclei in the medulla oblongata.
The vestibular apparatus may suffer from pathologies of the craniovertebral region of the skull, such as tumors on the brainstem. They mechanically affect the medulla oblongata, which causes such a pathological condition as ataxia.
This disorder may be a sign of an ischemic process in the brain stem, provoked by defective blood circulation. Such processes include atherosclerosis, high blood pressure, vascular aneurysms.
Another possible cause of vestibular ataxia is a traumatic brain injury. At the same time, it can be caused by the impact of a blow on the nucleus of the vestibular nerve and its roots or by a violation of full blood flow as a result of tissue damage.
Signs of vestibular ataxia
The main symptoms of vestibular ataxia are considered to be nystagmus, nausea and vomiting, dizziness, various kinds of vegetative abnormalities. Ataxia manifests itself both in motion and standing, when a person does not perform any manipulations. A distinctive feature of the disorder is that its manifestations depend on the movement of the head and trunk. In particular, the signs of ataxia increase at the moment when a person turns his head or looks from object to object.
As a result of vestibular ataxia, a person is deprived of the opportunity to fully move and perform elementary actions, and if they are necessary, they have to turn extremely slowly so as not to cause themselves discomfort. When closing the eyes, the patient feels even more insecure, and vision control relieves symptoms at the time when the movement is made.
In most cases, the vestibular apparatus has unilateral damage, which is why the disease is characterized by a shaky gait, a constant tilt of the body in the same direction. As a rule, the side to which the body deviates is the side of the lesion of the vestibular apparatus. This sign is especially clearly visible when the patient is trying to overcome any distance in the dark or with his eyes closed.
Vestibular ataxia may be accompanied by systemic dizziness. This is a feeling of smooth rotation of one’s own body, which can haunt the patient not only when moving, but also when standing and even sitting with closed eyes. Systemic dizziness may be accompanied by nausea and vomiting, redness or, conversely, paleness of the face, a violation of the rhythm of the heartbeat and pulse. Often the patient feels fear and excitement.
Nystagmus is most often observed in the horizontal position of the body. With horizontal nystagmus, the direction of deviation of the eyeball is opposite to the side of the lesion of the vestibular apparatus. There may also be a vertical nystagmus, according to which it is not possible to identify the side of the lesion. An increase in nystagmus when moving or tilting the head indicates violations of the periphery of the vestibular apparatus.
Diagnosis of vestibular ataxia
When vestibular ataxia is detected, the patient undergoes several stages of diagnosis. At the first stage, he is asked to take the Romberg pose — with his eyes closed, you need to close your legs together and stretch your arms forward. After taking this pose, the patient should touch the tip of his nose with his finger.
The second variant of the ataxia test is touching the left heel of the knee of the right leg. Then it is necessary to repeat this movement in reverse and return to the starting position.
Stabilometry
As the most accurate method of diagnosing such a pathological condition as vestibular ataxia, stabilometry is used in modern medicine. This is a method of functional diagnostics that allows you to objectify the fluctuations of the center of gravity of the human body over the support area. In other words, stabilometry is an electronic analyzer that helps to find out how much the patient is able to maintain balance.
The method of stabilometry is based on the use of computer technology and a special stabilometric platform. The use of innovative equipment makes this study as accurate as possible and allows it to be applied not only in neurology, but also in other areas of medicine. During the stabilometry, the tested patient stands on the platform and performs a number of necessary movements within one minute according to the instructions of a specialist.
Other diagnostic methods
There are several other diagnostic methods by which vestibular ataxia can be detected. The patient’s brain is examined using electroencephalography, MRI, electromyography. In some cases, DNA diagnostics and additional tests are carried out:
laboratory blood test;
psychiatric examination;
neurologist and optometrist.
The totality of data obtained from all these studies gives a complete picture of the patient’s condition and allows us to judge the extent of damage to the vestibular apparatus. On their basis, the attending physician makes a diagnosis and prescribes treatment adequate to the patient’s condition.
Treatment of vestibular ataxia
The therapy recommended for patients with this diagnosis is primarily aimed at eliminating the cause of the pathology. In the case of an infectious lesion of the auditory organ, antibiotic treatment, middle ear washing, sanation surgery or labyrinthotomy are performed. These procedures eliminate the focus of purulent lesions and allow you to get rid of disorders of the vestibular apparatus.
When ataxia is caused by vascular disorders, drugs designed to improve blood supply to the brain are used for treatment. If the brain has severe abnormalities and medical treatment is not appropriate, surgical correction methods are used. Surgical intervention is especially often performed in the presence of large formations, such as arachnoiditis or encephalitis.
As for ataxia itself, its therapy is carried out at the level of eliminating symptoms. As a rule, it consists in prescribing drugs to the patient that affect the metabolism and work of nerve cells. The list of such medicines includes muscle relaxants, nootropics and anticonvulsants:
ginkgo biloba;
nootropil;
Aminalonum;
cerebrolysin;
vitamins of group B.
One of the methods of treatment of vestibular ataxia is a special set of exercises of physical therapy, selected by a professional trainer. The main purpose of these exercises is to train and consolidate the coordination of movements, as well as strengthen the muscle tissues in the patient’s body. As an addition to physical therapy and even as a possible alternative to it, the patient may be prescribed exercise walking and occupational therapy.
Ataxia cannot be treated independently and its correction is impossible without the participation of a doctor. Only an examination by a specialist and diagnosis in a clinic allows you to identify the main symptoms and causes of their occurrence. In working with patients who have this anomaly, an individual approach is important, since the set of signs of deviations in all subjects may be different.
If the disease is hereditary, its treatment may be difficult, and the symptoms sometimes do not weaken for several years.
Prevention of vestibular ataxia
There are no warning methods specifically for ataxia. To protect yourself from its appearance, you should pay special attention to the prevention of acute infectious diseases that can injure the vestibular apparatus: sinusitis, pneumonia, otitis media and the like.
There is an extremely high probability of developing ataxia in children born from consanguineous marriages. For this reason, and not only, it is imperative to avoid such unions. It is also necessary to remember that hereditary ataxia already detected in one of the parents will almost certainly be observed in his offspring. Some patients are advised by experts to refrain from giving birth to their children and resort to adoption.
