Vestibular system

Proust quote

~ Marcel Proust

Lara’s quote this week references looking at the world through new eyes and it made me think of how disorienting the world is if something messes with our vision! For example…vertigo. If you’ve never had it, lucky you! If you have, you are fully aware of how your vision can be affected by it.

Vertigo is caused by a disruption to the vestibular system, which is a complex set of structures and neural pathways that helps us maintain balance and spatial orientation. It does so by detecting the position and movement of our head in space. There is a vestibular apparatus in the inner ear where this whole process begins. It sends signals to multiple places in the body, including the eyes and central nervous system. This is all reflexive, or unconscious. The activity between the vestibular system and the eyes is called the vestibulo-ocular reflex (VOR), which allows the eyes to remain fixed on an object while the head is moving. The activity between the vestibular system and the spine is called the vestibulospinal reflex (VOS), which coordinates the muscles of the spine with head movement to maintain balance and posture.

Any disruption along the pathway can lead to various symptoms including vertigo, imbalance, nausea, vomiting, visual disturbances, hearing changes, and uncoordinated eye movements. When you have vertigo, it can feel like the world is spinning despite the fact that you’re lying completely still. As a result of this vestibular disruption, dizziness, nausea, and vomiting can occur. The most common type of vertigo is benign paroxysmal positional vertigo (BPPV), which usually only lasts for seconds to minutes. It is believed to be due to the displacement of tiny crystals in the ear canals called otoconia which causes an inappropriate sensation of movement. I suffer from occasional bouts of BPPV, which luckily only last a couple of seconds but can be very disorienting. In my case, when I turn my head, my vision stutters hard back and forth for a second or two and I feel a sudden onset of dizziness. It goes away as quickly as it comes on but can leave me feeling a little nauseated. Most people report having a spinning of their visual field, which often causes a loss of balance coupled with nausea and/or vomiting. A hallmark of BPPV is nystagmus, which is uncoordinated eye movement in response to moving the head. So when a person’s head is turned in one direction, the eyes will beat quickly back and forth, indicating a failure of the VOR to work.

Meniere disease is another type of vertigo that can last for hours with the same symptoms as BPPV but also includes hearing loss and tinnitus, or a ringing in the ears. With Meniere, there is an expansion of fluid in the ear, impacting the vestibular apparatus. My dad suffers from Meniere disease, so clearly vertigo runs in the family! In his case, he will typically have it right upon waking in the morning and he immediately feels nauseated. If he tries to get out of bed, he will have violent episodes of visual spinning and vomiting. It can last for the entire day. By the next day, although tired, he usually feels fine.

Another type of vertigo is viral labyrinthitis, which is caused by inflammation of the vestibular nerve as a result of a viral infection. Symptoms can last from days to weeks and include hearing loss in the ear that is affected and a loss of balance. These three forms of vertigo are called peripheral because they include the inner ear as the main source of vestibular disruption. There are also forms of vertigo caused by central nervous system lesions in the brainstem, pons, or cerebellum, which are much more serious in nature. Central vertigo can be the result of a stroke, multiple sclerosis, toxicity due to medication, tumors, etc.

It’s not until you lose your vision that you really appreciate its role not only in daily function but in balance and proprioception. In LYT Yoga, I like to create classes that challenge the brain and body by purposely affecting the vestibular system through movements of the head or closing the eyes. It not only heightens our appreciation of this intricate and vital ability but helps to train each individual portion, making us stronger in the long run. Click the link below to check out my class “Toe The Line” and see how your vestibular system is working! Until then, I’ll see you on the mat!



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