In most cases of acute loss of function of an organ of balance (AUVP = acute unliateral vestibulopathy), no underlying cause can be found. We then speak of neuropathia vestibularis. This is also known as vestibular neuritis, as the disease is thought to be caused by the reactivation of herpes simplex viruses in the nerve cells of the vestibular system. An acute loss of the organ of balance can also be triggered by an inflammation of the middle ear that spreads to the inner ear (so-called labyrinthitis) or by a craniocerebral trauma (contusio labyrinthi) or a fracture of the base of the skull in the area of the bony inner ear (so-called petrous bone fracture).
In rare cases, the symptoms of acute loss of balance are caused by a circulatory disorder (labyrinth ischemia) or a hemorrhage in the inner ear (labyrinth hemorrhage).
If the vestibular organ does not recover after an acute loss, the missing function is compensated for by the brain and the vestibular organ on the opposite side (so-called vestibular compensation). As compensation increases, the symptoms of the acute balance disorder diminish over the course of weeks and months.
Chronic loss of a vestibular organ is caused, for example, by a benign tumor on the vestibular nerve(vestibular schwannoma), Meniere’s disease or an autoimmune disease of the inner ear. Central-vestibular compensation is also possible here.
Treatment
Acute loss of balance is usually treated with corticosteroids (a type of cortisone) in tablet form. We know from clinical studies that this therapy increases the likelihood of recovery of the vestibular system. In the first few days, additional medication is used to relieve the dizziness and nausea (so-called antiemetics, antivertiginosa). After that, these drugs are deliberately no longer used so as not to impair the compensation of the balance function in the brain.
In the case of chronic loss of balance, the therapy depends on the underlying disease. In both cases, specialized balance training to promote compensation is essential(vestibular physiotherapy).
Why the USZ
The Center for Dizziness and Neurological Visual Disorders provides interdisciplinary clarification of possible differential diagnoses of acute or chronic loss of function of the vestibular organ (e.g. vestibular schwannoma, Menière’s disease, circulatory disorder of the vestibular organ/brain). Depending on the cause, an individual therapy concept is created for each patient.
Vestibular physiotherapy provided by the Department of Physiotherapy and Occupational Therapy plays a particularly important role here. Our therapists specialize in the rehabilitation of vestibular disorders and will work with you to develop an individual training program so that you soon have both feet firmly on the ground again.