Common Vestibular Dysfunctions

There nearly 54 million people suffering from various other vestibular disorders. “1 in 5” people in the world are affected by some or the other vestibular disorders.

Few most common vestibular dysfunctions are:

1. Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is the most common cause of vertigo. A short-lived, strong episode of vertigo activated by a specific change in the position of the head. There are both severe and mild forms of BPPV, which lead to different clinical symptoms.

2. Vestibular Neuronitis/Neuritis
Vestibular Neuronitis is characterised by severe and sudden onset vertigo, which is caused by inflammation of the vestibular nerve and often accompanied with nausea and vomiting.

3. Unexplained dizziness
Sometimes it very difficult, particularly in the acute phase to determine the cause of dizziness. it is important see neurotherapeutic doctor to ensure and eliminate any serious problem if any .

4. Falls
Many factors contribute to falls in the elderly and in those with neurological disorders such as stroke, Parkinson’s and Multiple Sclerosis. It is essential to have an assessment that screens the physiological systems that contribute to falls risk.

5. Ataxia
Poor co-ordination, tremor and reduced postural stability and balance create difficulties with many activities of daily living. There are many conditions that cause ataxia including stroke, multiple sclerosis and brain injury.

6. Migraine
Migraine is a common disorder of central sensory processing. It leads to  episodic symptoms, the most common of which is headache. However, migraine does not always cause headache, with some rare forms of migraine leading to dizziness. Other symptoms such as nausea, vomiting and light and noise sensitivity are common.

7. Meniere’s Disease
Meniere’s disease is a rare, chronic ailment that lead to episodic attacks of dizziness, nausea and vomiting, often with slow deterioration in the ability to balance and one-side hearing loss.

8. Endolyphatic Hydrops
Endolymphatic hydrops result in episodes of dizziness, imbalance and hearing changes.

9. Labyrinthitis
Labyrinthitis is an infection within the inner ear, which causes vertigo and imbalance sensations.

10. High Level gait disorders
Many people develop problems with walking, such as intermittent difficulty in walking, reduced confidence, and slow or shuffling steps.

11. Cervical Vertigo
In some cases, problems with the neck leads to feelings of dizziness and disequilibrium.

12. Perilymph fistula :
It is leakage of inner ear fluid into the middle ear. Perilymph fistula can occur after a head injury, dramatic changes in air pressure, physical exertion, ear surgery, or chronic ear infections.

13. Mal de Debarquement syndrome:
A feeling of continuously rocking or bobbing, typically after an ocean cruise or other sea travel. Usually the symptoms go away a few hours or days after you reach land. Severe cases, however, can last months or even years, and the cause remains unknown.

14. Acoustic Neuroma :
An acoustic neuroma is a benign (non-malignant), usually slow-growing tumour that develops from the nerves of inner ear.

15. Bilateral Vestibular Hypofunction:
Reduction or loss of vestibular function bilaterally results in difficulty maintaining balance, especially when walking in the dark or on uneven surfaces, and a decrease in the patient’s ability to see clearly during head movements.

16. CANVAS Syndrome :
Patients with CANVAS combine cerebellar ataxia (i.e. coordination problems -- the CA), peripheral nerve damage (neuropathy - N), and loss of vestibular function (vestibular areflexia -- the VA). This combination causes major disturbances to balance as each of these systems alone contributes to balance.

17. Concussion :
Concussion can occur under the following conditions:
The head strikes a stationary object.  Common examples include a fall where the head hits the ground or an object, or hitting the head on an object during an auto accident.
An object hits the head, such as a ball or stick during sports, or because of human collision.
A quick acceleration/deceleration of the head with no contact to any surface.  This can occur in dancers and gymnasts due to rapid movement, or during an auto accident where there appears to be no head trauma.
Trauma to the brain can result in abnormal vestibular system functioning, and the brain can receive abnormal signals regarding the position and movement of the head in space.

Cerebral Palsy & Types

Cerebral Palsy : Nearly 170 million people throughout the globe are affected by Cerebral Palsy with 25000 additional people every year according to world Cerebral Palsy Day organization Australia. Cerebral palsy is a Non curable disease caused by injuries or abnormalities of the brain at young age or low oxygen supply at any age.At present it is the most commonly occurring developmental disorder in the world. 3 to 4 children per 1000 births develop this condition by birth and many get affected in the early stages of growth.
Some important effects of cerebral palsy are Muscle tightness and spasticity, difficulty in moving or involuntary movements – This can include disturbances in gait, balance, coordination, walking, staying still, and more depending on an individual's condition and the affected areas of the brain. Mental Retardation, Learning disabilities, Breathing Difficulties – because of postural problems, feeding trouble – the muscles used for feeding may be impaired in people with cerebral palsy. This can lead to malnutrition and troubles with development and growth. There is no cure except occupational & physical therapy with supplementary medicines for this disorder.

Types of Cerebral Palsy:Cerebral palsy is categorized using two factors: the type of movement issues and the body part(s) being affected.

There are four types of cerebral palsy namely spastic, athetoid, ataxic and mixed type.
The type of movement problems seen in Cerebral Palsy Children/individuals depends on how severely a brain injury has impacted muscle tone. Muscle tone is the strength and tension of the muscles.
Terms used to describe how cerebral palsy affects muscle tone are
• Hypotonia – Low muscle tone, causing a loss of strength and firmness
• Hypertonia –  High muscle tone, causing rigidity and spasmodic movement
Different Types of Cerebral Palsy
• Spastic
• Athetoid
• Ataxic
• Mixed

Spastic Cerebral Palsy : Spastic cerebral palsy is the most common type of CP, making up 70 to 80 percent of cases. People with spastic cerebral palsy often experience exaggerated or jerky movements (hypertonia).
Common signs and symptoms of spastic cerebral palsy include:
• Awkward reflexes
• Stiffness in one part of the body
• Contractures (permanently tightened muscles or joints)
• Abnormal gait

Athetoid Cerebral Palsy :  About 10 percent of children with cerebral palsy are identified with athetoid CP, or “non-spastic CP”. This type of CP is characterized by a mixture of hypotonia and hypertonia, which causes muscle tone to fluctuate. The main feature of athetoid cerebral palsy is involuntary movement in the face, upper body and limbs.
Common symptoms related with athetoid cerebral palsy are:
• Stiff or rigid body
• Floppiness in the limbs
• Problems with posture
• Issues feeding

Ataxic Cerebral Palsy: Ataxia is a type of CP that causes problems with balance and coordination. Ataxic cerebral palsy makes up a small percentage of all cases.
Common symptoms of ataxic cerebral palsy include:
• Difficulty speaking
• Problems with depth perception
• Shakiness and tremors
• Spreading feet apart when walking

Mixed Cerebral Palsy: When a child is showcasing symptoms of more than one type of CP, it is mixed cerebral palsy. This diagnosis makes up less than 10% of all CP cases. The most common mixed cerebral palsy diagnosis is a combination of spastic and athetoid CP

Location of Movement Problems
Monoplegia: Only one limb’s movement of the individual is affected. This type is very rare.
Diplegia: Two limbs, generally the legs, are affected. Premature birth commonly results in Diplegia.
Hemiplegia: One side of the body is affected. The arm is usually more impacted than other limbs, distinguished by a rigidly flexed wrist or elbow. Some people with hemiplegia may not be able to use the affected hand. Prenatal bleeding in the brain can cause hemiplegia.
Triplegia: Three limbs are affected.
Quadriplegia: All four limbs are involved, but the legs are affected worse than the arms. There may be limited control over facial muscles as well.
Double hemiplegia: Like quadriplegia, all four limbs are affected, but the arms are more affected than the legs.