Characteristic features of the manifestation of vestibular ataxia and its treatment
Vestibular ataxia is a pathological condition in which movement coordination is impaired and the ability to maintain balance in a particular posture due to a disruption in the structure of the vestibular apparatus. A person with such a symptom can not remain stable while sitting, standing or walking. In addition, he may have other signs of lesion - nausea, vomiting, nystagmus, abnormalities in the autonomic nervous system.
Since the lesion of the vestibular apparatus develops as a sign of another pathological process, for an objective diagnosis it is necessary to take into account the symptomatology of the disease that formed the basis for the manifestation of vestibular ataxia.
How does this state arise?
Any level in the disturbance of the vestibular apparatus( cortical center of the temporal lobe of the brain, the core of the trunk, the vestibular nerve) can lead to the development of this pathology. Changes in these structures usually occur with the following diseases:
- inner ear inflammation( labyrinthitis) with a breakdown in the structure of hair cells;
- trauma to the skull;
- transition of the inflammatory process in acute or chronic otitis media;
- ear tumor with invasive growth;
- toxic effect of ear cholesteatoma;
- Ménière's disease( characterized by paroxysmal vestibular attack);
- toxic effects of drugs;
- viral infection;
- encephalitis, arachnoiditis;
- chronic cerebral ischemia or stroke;
- hypertension;
- atherosclerosis of vessels or aneurysm;
- circulatory disorders in the basins of vertebrates or labyrinthine arteries.
Symptoms accompanying vestibular ataxia
There are static( standing) and dynamic( walking) vestibular ataxia. A very characteristic feature that distinguishes it from other types of ataxia is an increase in instability in circular movements of the head or trunk. Therefore, the patient tries to avoid pronounced movements and does it extremely slowly. Symptoms manifest themselves in the absence of visual control of movement.
Almost always one side of the vestibular apparatus is affected, and the body of the patient deviates when it is moved to this side. Also, with such a symptom, nystagmus can manifest. Muscle strength and proprioceptive sensitivity in the vestibular form of ataxia persists in the normal volume. Sometimes there is a decrease or loss of hearing. In Meniere's disease, patients often complain of ringing in their ears.
Another characteristic feature for such a pathology is the presence of systemic dizziness. It occurs in some patients even in a horizontal position and with closed eyes. This leads to difficulty sleeping and sleep disorders. Vestibulo-visceral connections in the defeat of the vestibular apparatus provoke nausea and vomiting, and on the part of the autonomic nervous system, a reaction is noted in the form of reddening of the skin, rhythm or tachycardia, increased sweating, spasmodic pressure fluctuations.
How to treat vestibular ataxia
Because vestibular ataxia is not an independent disease, but only a symptom, all efforts should be made to eliminate or alleviate the underlying illness.
Inflammatory processes of the middle or inner ear are stopped by the appointment of antibacterial drugs, washing, sanitation, or surgical removal of purulent foci.
If the cause is a tumor process, taking action is to determine the exact location and variety of education. If it is possible to delete it, an operation is performed. In another case, palliative measures are used, limiting its further distribution.
Violation of the vascular circulation is stopped by numerous variants of drugs that improve the rheological properties of blood, lowering the level of cholesterol, stabilizing blood pressure.
Craniovertebral anomalies also often require radical surgical intervention - labyrinthectomy. Produced in the most extreme cases, as it leads to complete deafness.
Meniere's disease uses diuretic drugs, sedatives, a diet with a decrease in the amount of salt, a refusal of alcohol and beverages high in caffeine. Drainage of endolymphatic sac, chemical ablation of labyrinth tissues with the use of ototoxic antibiotics is carried out. In the period of the attack, antihistamines are used.
Symptomatic treatment for vestibular ataxia is aimed at improving cerebral circulation with nootropics, B vitamins. With severe nausea, antiemetics are used. An important role is played by exercise therapy, which helps improve coordination and strengthen muscles.
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