- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index
(p. 49) The Vestibulo-Autonomic System
- Chapter:
- (p. 49) The Vestibulo-Autonomic System
- Author(s):
Bill J. Yates
, Ilan A. Kerman
, Brian J. Jian,
, and Timothy D. Wilson
- DOI:
- 10.1093/med/9780199608997.003.0005
Many clinicians and scientists equate ‘vestibulo-autonomic responses’ with motion sickness. While motion sickness does include symptoms and signs such as pallor and cold sweating that result from the actions of the autonomic nervous system, considerable recent evidence shows that the vestibular system also participates in regulating blood distribution in the body and blood pressure during movement and changes in posture. This chapter reviews data collected in both animal and human subjects demonstrating the existence of vestibulo-sympathetic reflexes that act upon the cardiovascular system. This evidence shows that vestibulo-sympathetic responses are patterned, in that they differ between the upper and lower body. The neural pathways that mediate vestibulo-sympathetic responses are also described, which include projections from the caudal aspects of the medial and inferior vestibular nuclei to lateral regions of the caudal medullary reticular formation and the rostral ventrolateral medulla (RVLM). In turn, RVLM neurons relay vestibular signals to sympathetic preganglionic neurons in the thoracic spinal cord. Activity in this neural circuit is modulated by several brainstem regions, including nucleus tractus solitarius, the posterior cerebellar cortex, and likely others. Vestibulo-sympathetic responses are typically attenuated in conscious animals, and the gain of the responses appears to be modulated in accordance with ongoing behavioural activity. Finally, the clinical implications of vestibulo-sympathetic responses are discussed, as are the clinical symptoms that may result from dysfunction of the responses.
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- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index