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. 2009;30(4):231-241.
doi: 10.1055/s-0029-1241124.

Anatomical and Physiological Considerations in Vestibular Dysfunction and Compensation

Sherri M Jones  1 , Timothy A Jones, Kristal N Mills, G Christopher Gaines
Affiliations

Anatomical and Physiological Considerations in Vestibular Dysfunction and Compensation

Sherri M Jones et al. Semin Hear. 2009.

Abstract

Sensory information from the vestibular, visual, and somatosensory/proprioceptive systems are integrated in the brain in complex ways to produce a final motor output to muscle groups for maintaining gaze, head and body posture, and controlling static and dynamic balance. The balance system is complex, which can make differential diagnosis of dizziness quite challenging. On the other hand, this complex system is organized anatomically in a variety of pathways and some of these pathways have been well studied. The vestibulo-ocular reflex (VOR) is one such pathway. Understanding the anatomy and physiology of the VOR facilitates our understanding of normal and abnormal eye movements and research is advancing our understanding of the plasticity of the vestibular system. This review highlights anatomical and physiological features of the normal vestibular system, applies these concepts to explain some clinical findings in some common peripheral vestibular disorders, and discusses some of the research investigating the anatomical and physiological basis for vestibular compensation.

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Figures

Figure 1
Figure 1
Simplified schematic of the central vestibular pathways. The flow of information between relays and across the midline is depicted by the arrows. For clarity, connections are only shown for the left side. Parallel pathways exist on both sides of the brain. Adapted from Lysakowski et al. and McElligott and Spencer.
Figure 2
Figure 2
Schematic representation of the horizontal VOR from a dorsal perspective. The dashed line bisecting the figure represents the midline. Net excitation and inhibition (or deactivation) are indicated by the ‘+’ and ‘−‘ signs, respectively. See text for details. HSC – Horizontal Semicircular Canal, VNC – Vestibular Nuclear Complex, VI – Abducens Nucleus, III – Oculomotor Nucleus, LR – Lateral Rectus, MR – Medial Rectus
See this image and copyright information in PMC

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