The vestibular system is part of our sense of balance.The human balance system is complex. It involves three major systems working with the brain:
1) Vestibular system (inner ear sensors for balance): in the bone behind each ear we have a set of 5 little sensors, similar to accelerometers and gyroscopes on electronic devices. These sensors tell the brain the position of our head in space and all sorts of movements we make. The vestibular system works for us at all times, even when we are sleeping.
2) Visual system: our vision not only tells the brain what movements we are doing with our head but more importantly, help us feel stable when we move our head. The eyes work with the vestibular system on this important reflex called Vestibular-Ocular Reflex (VOR). It allows us to read a road sign when we are walking or running, for example.
3) Proprioceptive system: a large system in our body consisting of millions of little sensors (proprioceptors) on our skin, muscles and tendons. It gives us the sensation of our body in space. For instance, when we are standing up, the proprioceptors on our feet and ankles tell the brain we are bearing weight on them and must therefore be standing up.
These 3 systems send movement information to balance centres in the brainstem, a part of our brain on the back of the neck. The brain processes the movement information and figures out what adjustments we need to make on our body in order to maintain balance.
The goal of the vestibular assessment is to help determine whether the vestibular system (inner ear sensors for balance) is contributing to your dizziness. It may also help if it shows signs that the brain may actually be involved in the origin of your dizziness.
Knowing what part of this complex system is likely to be the culprit will help us plan an individualized treatment plan.
Jane has been given an exercise (self-Epley maneuver) to help with her vertigo caused by changes in head position, after a bedside testing (without goggles). She has performed that one exercise for several years, sometimes several times a month. It seemed to help her somewhat. However, she notices that it is not helping her anymore. She is sure she has crystals in another canal in the ear.
Our vestibular testing shows that she actually does not have crystals misplaced in the inner ear. Her actual problem is a strong sensitivity to motion, which is very likely related to her history of severe migraines. She is thankful that she was given a new set of exercises that are targeted at her current problems and is slowly making progress.