Vestibular Syndrome

What is Vestibular Syndrome?

The vestibule is present in the inner ear and apart from aiding hearing, the vestibular system plays an important role in body balancing and an innate sense of direction or spatial orientation in most of the mammals. A peripheral form of aliment excludes the interference of central nervous system affects inner ear and cause the vestibular syndrome.

The disorder in a peripheral nervous system which is connecting to inner ear and brain is attributed vestibular syndrome. The prominent effect of this syndrome is body balancing problem.

In most of the cases, Vestibular Syndrome is curable with identifying underlying cause and providence of correct treatment and supportive care. Vestibular Syndrome is common in a younger dog^1,2.

Causes

Peripheral involvement of vestibular syndrome is much more common than central nervous system participation. The included underlying causes are a persistent inner ear infection or middle ear infections which extend to the inner ear, recurring inner ear infection, attain a fiery ear cleansing process resulting in this cause eardrum, traumatic ear injury, hypothyroidism, stroke, ear tumor, polyps in the inner ear and brain fever (meningoencephalitis).

Apart from these disease conditions, prolong use of aminoglycoside antibiotics, including gentamicin, amikacin, tobramycin, neomycin and loop diuretics also cause vestibular syndrome due to their side effect.

The vestibular syndrome can occur as a congenital defect. Sometimes, unidentified cause or idiopathic vestibular syndrome is also common. In some cases, a brain tumor is the primary cause of vestibular syndrome development.

In rare cases, central vestibular diseases like inflammatory conditions, brain hemorrhage, traumatic injury in the brain, brain infection, cerebral blood circulation obstruction and malignancy expand to central nervous system^1,2,3.

Signs and Symptoms

The vestibular syndrome has following sign and symptoms.

• Head tilting
• Loss of coordination
• Head spinning and awkward
• staggering
• the feeling of falling down, even sometimes cause unexplained fall down
• Feeling of rolling
• Abnormal eye movement or nystagmus, which is characterized by involuntary, periodic, eye jerking arise from side to side or up and down

Body balancing problem also associated with dizziness, excessive saliva secretion, nausea, and vomiting.

If vestibular syndrome only affects one ear, then the direction of tilting head and spinning head will be on the affected side of the ear. The related nystagmus or abnormal eye movement only affects the particular side of the eye.

Vestibular syndrome mostly affects the dogs, who belongs to breeds of a German shepherd, Doberman pinscher, Akita, English cocker spaniel, beagle, smooth fox terrier, and the Tibetan terrier. The Congenital vestibular syndrome affected dog are shows the symptoms within three months of his age^1,2,3,4.

Diagnosis

The following stage wise Vestibular syndrome diagnosis is performed.

• A thorough physical examination with a neurological assessment provides the guidance of vestibular syndrome is either peripheral or central.
• In the case of the peripheral vestibular syndrome, often otoscope use for examining the inner ear.
• Some doctor ordered X-ray of the affected side or both the side of the skull to identify the presence of injury.
• Blood tests are conducted for identify presence of inflammatory factors.
• Any secretion from ear canal need to do culture test for identification of infectious agent
• Neurological sensitivity test require for identify central nervous system involvement sensitivity
• Cytology of pus need to check for eliminating the other potential causes of specific symptoms
• Presence of tumor or polyps need surgical biopsy
• Magnetic Resonance Imaging (MRI), Computer Tomography (CT) scan and spinal fluid taps are a different test required if physical examination provides an indication of center nervous system involvement. MRI, CT scan or spinal fluid taps require identifying the underlying cause¹.

Treatment

Congenital vestibular Syndrome and geriatric form of vestibular Syndrome do not have specific treatment to cure the condition. However, symptomatic relief can be obtained by using medications like anti-emetic drugs are prescribed to control nausea and vomiting.

Depending upon the underlying cause treatment plan is made.

• Antibiotics usually prescribed for infectious vestibular Syndrome and easily manageable.
• Anti-inflammatory drugs are prescribed to reduce the inflammation.
• Withdrawal of aminoglycoside antibiotics and loop diuretics also provide relief from its ototoxicity related vestibular Syndrome
• Thyroid hormone therapy is provided in case of hypothyroidism.
• Surgical intervention need to apply for tumor or polyp development

The central nervous system involvement or cancer-related vestibular Syndrome provide very poor treatment prognosis.

Some alternative treatment approaches also well accepted, which include homeopathy and acupuncture etc. Dizziness and related complaint can be managed by maintaining a proper diet and walking on open space, where sufficient oxygen supply is present.

Apart from these treatment approaches, vestibular Syndrome affected mammals require supportive therapy, which may obtain from proper nursing care and rehabilitation therapies^1,2,3.

References

1. By Dr. Becker; If Your Dog Suddenly Starts Circling or Staggering, This Could Be Why; Retrieve from http://healthypets.mercola.com/sites/healthypets/archive/2012/06/04/canine-vestibular-disease.aspx
2. Vestibular Disease; fitzpatrickreferrals; Retrieve from http://www.fitzpatrickreferrals.co.uk/neurology/vestibular-disease/
3. Vestibular Syndrome; Cornell University, College of Veterinary Medicine; Retrieve from http://www.vet.cornell.edu/fhc/Health_Information/vestibularsyndrome.cfm
4. Kerri Fivecoat-Campbell; Vestibular Disease in Dogs; Retrieve from http://www.petmd.com/dog/conditions/neurological/vestibular-disease-dogs