Vestibular Hypofunction

Vestibular hypofunction is a rare balance disorder. It can happen if illness or injury damages your vestibular system (inner ear). This system senses motion and gravity. It works with your eyes and tissues like muscles and joints to send information to your brain. Your brain uses the information to help you keep your balance.

In this disorder, the vestibular system in one or both ears stops working. So, your brain gets incomplete or wrong information and can’t manage balance. You end up feeling unsteady on your feet and dizzy. You may fall for no apparent reason.

Vestibular hypofunction types

The two types of this disease can affect you in different ways:

• Unilateral vestibular hypofunction: This type affects one ear. In this type, your brain literally gets mixed signals from your ears’ vestibular systems. It’s the most common form of the disease.
• Bilateral vestibular hypofunction: People with severe forms of this disease may feel “off-balance” even when they’re sitting or lying down. Their balance issues may get worse very slowly. In some cases, they don’t notice their balance issues until they have falls that happen often and for no reason.

Symptoms of vestibular hypofunction

Your symptoms may include:

• Balance issues
• Blurred vision
• Difficulty concentrating
• Dizziness and vertigo
• Falls
• Fatigue
• Nausea

Condition causes

Several things may cause vestibular hypofunction, like:

• Age: Your vestibular system weakens as you get older. This disease typically affects people 55 and up.
• Disease: Infections like labyrinthitis and vestibular neuritis may cause this disease. Meniere’s disease is another illness that can lead to vestibular hypofunction.
• Head injuries: A concussion or traumatic brain injury that damages your inner ear can cause it.
• Ototoxicity: Antibiotics and some cancer medications may damage the sensory cells in your inner ear. These cells help you maintain your balance. Ototoxicity is the most common cause of vestibular hypofunction in both ears.

Complications of vestibular hypofunction

The condition causes symptoms that may make it hard for you to work, drive or do routine daily activities. Missing work or not being able to do everyday tasks may make you feel anxious and depressed.

Bilateral vestibular hypofunction that lasts more than three months can lead to persistent postural perceptual dizziness (PPPD).

How doctors diagnose this condition

A healthcare provider will ask about your symptoms and medical history. They’ll do tests to check on your vestibular system. You may have tests like:

• Caloric: In this test, your provider places warm or cool water in your ear canal. The temperature change should trigger specific rapid eye movements.
• Rotary chair: This test shows how well your eyes and vestibular system work together to keep your vision focused while you’re in motion.
• Videonystagmography (VNG): This test checks for uncontrollable eye movement (nystagmus).
• Vestibular evoked myogenic potentials (VEMP): This test focuses on two tiny organs in your inner ear (otolith organs). These organ sense when your body moves back and forth or up and down.

How is it treated?

Vestibular rehabilitation therapy (VRT) is the most common treatment. It involves different exercises to help you manage symptoms like dizziness and balance issues. For example, you may do eye control exercises or have balance retraining.

When should I seek care?

You should talk to a healthcare provider if you have frequent dizzy spells and vertigo. Likewise, talk to a provider if your sense of balance feels off or you experience falls. Many things can cause these issues. A conversation with your provider will help you understand what may be going on with your body.

What can I expect if I have vestibular hypofunction?

Treatment often eases symptoms so they don’t interfere with your daily routine. But some people with long-term bilateral vestibular hypofunction may still need to deal with balance issues and other symptoms.