What are Vestibular Senses?

The vestibular senses are awareness of body balance and movement. These functions are monitored by the vestibular system. The vestibular senses (the sensation of body rotation, gravitation, and movement) arise in the inner ear. The sense organs are the hair cells that send out signals over the auditory nerve.

Body rotation sensations arise in three semi-circular canals in the inner ear. The hair cells in the inner ear are stimulated by the movement of fluid in the inner ear, which sends out signals to the brain about the speed and direction of body rotation.

Gravitation and movement sensations are produced by two vestibular sacs in each ear that lie between the semi-circular canals and the cochlea. The sacs are filled with tiny crystals that bend the hair cells when moved which in turn sends impulses to the brain giving a sense of position. Motion sickness is an example of overstimulation of the vestibular organs.

The vestibular senses respond to changes in your head position or having your feet lifted off the ground and contribute to balance and equilibrium. Because of this, vestibular input is vital to a child’s development because it helps them to maintain balance and body control and to interact with their environment for fine motor, visual motor, gross motor, sporting activities, and self-care. Vestibular input can also help a child to feel regulated and keep them focused and attentive.

Some activities that provide vestibular input are as follows:
  • Somersaults
  • Log rolls
  • Rolling inside a barrel
  • Prone or inversion on a large exercise ball
  • Swinging
  • Hanging upside down
  • Sit and spin
  • Merry go round
  • Hammock
  • Roller coasters
The brain uses information from the vestibular senses in the head and from proprioception throughout the body to understand the body’s dynamics including its position and acceleration from moment to moment.

What are Vestibular Disorders?
Disorders of the vestibular system can take different forms and usually induce vertigo and instability or loss of balance often accompanied by nausea. Vestibular disorders have been found to correlate with cognitive and emotional disorders including depersonalization and derealization.

When our vestibular senses are regulated, we don’t notice they are there. Walking without stumbling can be taken for granted. However, with impaired balance, simple activities can become tiresome, and often dangerous. Symptoms that accompany the unsteadiness can include dizziness, hearing and vision problems, and difficulty with concentration and memory.

Some of the more commonly researched vestibular disorders are:
Acoustic Neuroma: a serious but non-malignant tumour that develops on the sheath of the inner ear vestibulocochlear nerve. As the tumour grows, it compresses the nerve, causing hearing loss, dizziness, tinnitus, and loss of balance.

Age-Related Dizziness and Imbalance: vestibular disorders make up 50% of dizziness issues in older people. Dizziness and loss of balance can affect any age group, but when it affects seniors, the risk of falling due to imbalance, and more serious injury is far greater.

Autoimmune Inner Ear Disease: Autoimmune issues in the inner ear are often caused by a malfunction of the immune system attacking its cells to invade viruses or germs that attack the healthy cells. This causes progression of damage and loss of function in the inner ear.

Benign Paroxysmal Positional Vertigo (BPPV): BPPV is a common disorder that causes vertigo, dizziness, and other symptoms because of debris that has collected within the inner ear. With head movement, this debris produces false signals to the brain.

Bilateral Vestibular Hypofunction: Reduction or loss of vestibular function in both ears. This can make maintaining balance very difficult and decrease a person’s ability to see clearly during head movements.
Canvas Syndrome: CANVAS is an acronym for Cerebellar Ataxia, Neuropathy, and Vestibular Areflexia. Patients with CANVAS combine these conditions which cause significant disturbances to balance.

Cervicogenic Dizziness: Dizziness accompanied by neck pain. Sometimes it can be hard to differentiate between whether it’s the neck pain causing dizziness or vice versa.

Cholesteatoma: A skin growth that occurs abnormally in the inner ear behind the eardrum and causes damage to the tiny bones in the inner ear. Hearing loss, dizziness, and facial muscle paralysis can become apparent.

Concussion: Concussions are caused by a traumatic injury to the brain varying in degree and can cause loss of consciousness, dizziness, and vertigo, as well as headaches, loss of balance, and short-term memory loss.

Enlarged Vestibular Aqueduct Syndrome (EVAS): Usually accompanied by an enlarged endolymphatic duct, causing hearing loss and balance disturbances that impair nerve signals to the brain.

Labyrinthitis and Vestibular Neuritis: Resulting from an infection that inflames the inner ear, it causes dizziness or vertigo, and hearing changes. The two can occur together or independently.

Mal De Debarquement: ‘Sickness of Dismemberment’ is the motion sickness felt after traveling by ship, plane, or train. With a new and different movement, the body has to adjust back to its ‘land legs’. (In the interim, people will feel motion sickness on land.)

Migraine Associated Vertigo (MAV): Migraines are often associated with headaches, but can cause several vestibular disorders including dizziness and vertigo, with or without pain.

Meniere’s Disease: A vestibular disorder that produces a recurring set of symptoms as a result of abnormally large amounts of fluid collecting in the inner ear. The symptoms include vertigo, tinnitus, feeling of fullness in the ear, and fluctuating hearing.

Neurotoxicity: poisoning of the neurons in the brain that help control balance as a result of exposure to a neurotoxin such as lead.

Otosclerosis: The abnormal growth of bone in the middle ear that prevents structures within the ear from working properly and causes different types of hearing loss, dizziness, and loss of balance.

Ototoxicity: ‘Ear poisoning’ due to exposure to drugs or chemicals that damage the inner ear which sends balance and hearing information to the brain. Results can be permanent or temporary.

Paediatric Vestibular Disorders: more research is finding that vestibular disturbances are quite common in children with consequent challenges with gaze stability, balance ability, or development of balance abilities and dizziness.

Perilymph Fistula: A tear or defect in one of the small thin membranes that separate the middle ear from the fluid-filled inner ear causing changes in middle ear pressure that affect balance and hearing.

Persistent Postural Perceptual Dizziness (PPPD): symptoms include non-vertigo dizziness and unsteadiness that is increased by a person’s motion, or exposure to environments with complex or moving stimuli, (and) affecting the performance of tasks that require precise visual focus.

Secondary Endolymphatic Hydrops (SEH): recognized by abnormalities in the quantity, composition, and pressure of the inner ear fluid resulting from head trauma or ear surgery.

Superior Semi-circular Canal Dehiscence: results in an opening in the bone overlying the uppermost semi-circular canal within the inner ear which leads to fluid being displaced by sound and pressure, causing vestibular symptoms.

Tinnitus: Not a vestibular disorder on its own, but a symptom of many. Tinnitus is abnormal noise perceived in one or both ears. It can be experienced as ringing, hissing, whistling, buzzing, or a clicking sound, and can vary in pitch and duration.

Vestibular Hyperacusis: The perception of an unusual auditory sensitivity to some noises or tones. It is an abnormal condition in which electrical signals generated by sound vibrations are misinterpreted, confused, or exaggerated. You may feel pain, discomfort, or annoyance when certain sounds are heard.

Vertebrobasilar Insufficiency: When blood flows through the basilar arteries in the inner ear is restricted and causes vertigo without warning, especially in the elderly. Vertigo usually lasts several minutes and can be accompanied by nausea, vomiting, headache, and impaired vision.

When people, especially children, have challenges with their sensory systems accompanying disorders such as Autism Spectrum Disorder, they will often feel symptoms associated with vestibular disturbances. Most children with sensory issues will see an occupational therapist who will look at their symptoms and design a program of physical therapy, sound therapy, and sensory regulation to help with the symptoms and the behavioural or social/emotional challenges that come with not understanding noise about their environments.

Many children respond very well to regulating their sensory systems through compression therapy like JettProof because it calms and soothes an overstimulated sensory system making it easier for a child to focus on more important learning.

Vestibular disturbances are treated in many different ways. Be sure to research all appropriate therapies and talk to your doctor or therapist before starting any new treatment for your child.

The form of treatment recommended for your child by their team of professionals will depend on their symptoms, the severity of them, and possibly treatment for an underlying condition causing vestibular disturbances. Treatment can range from medication to surgery, occupational or physical therapy, sensory regulation, and home-based exercise. In some cases, a simple diet change may be in order.

Although uncomfortable, vestibular disturbances and disorders can be easily treated, and in some cases, cured. A holistic and integrative approach to vestibular conditions is usually what is recommended by the team responsible for the care of your child. Do what feels right for you and your child. As a parent, you know your child best.