‘Vestibulopathy’ refers to a disorder of the vestibular system. We use 3 systems to gather information about our body position and the world: Vision, Vestibular, and Somatosensory. So, the vestibular system is one of three pillars keeping us balanced.

The vestibular system is located in the inner ear and acts as our body’s gyroscope so that we know when our head is moving, tilting, or rotating, and in which directions. When there is a problem with the vestibular system, we may experience a general sense of dizziness, vertigo (a sensation of moving), and difficulty balancing/walking. Acutely, we may even vomit.

There are three common vestibular disorders (although more exist). These include Benign Paroxysmal Positional Vertigo (BPPV), also called ‘Loose Crystals’, Labyrinthitis, and Vestibular Neuritis.

BPPV

To understand BPPV, we need to learn a little bit of inner ear anatomy. The peripheral vestibular system is comprised of 2 fluid-filled chambers (Utricle and Saccule), and 3 canals that begin and end in the Utricle. Inside of the utricle, are hair cells that move when we move our heads. This motion sends a signal along a nerve to the brain, and we perceive motion. On top of these hair cells sit crystals (called otoconia) that are held down and do not move. They help our brain detect where the ground is, because when we tilt our heads, the crystals want to fall toward the ground and make the hairs bend (sending signals along the nerves to the brain).

When the crystals become unattached from the matrix that holds the hair cells, they are free to fall and move whenever we pitch our heads or roll in bed. This creates an unexpected reaction to other hair cells in the vestibular system and is interpreted by the brain as ‘spinning’. Our eyes even move in reaction, and we may even see the room spin! 

Physician’s and Therapists specialized in the inner ear are able to roll you in such a way as to put the crystals back where they belong, and the vertigo stops.

Labyrinthitis

This is an infection of the inner ear, and is usually caused by a virus, but at times is bacterial. When you have labyrinthitis, you may experience vertigo, nausea, vomiting, dysequilibrium, and fluctuating hearing loss in the ear that has the infection.

Vestibular Neuritis

This is another infection (usually viral) that attacks the vestibular nerve that carries signals from the inner ear to the brain. You may experience the same symptoms as labyrinthitis but without hearing loss. Typically, it takes about 2-3 weeks to go away on its own, but your physician my give you medications to relieve symptoms.