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Multisensory Interaction and Vestibular Compensation 

Multisensory Interaction and Vestibular Compensation
Chapter:
Multisensory Interaction and Vestibular Compensation
Author(s):

Ian S. Curthoys

and G. Michael Halmagyi

DOI:
10.1093/med/9780199608997.003.0006
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date: 30 July 2021

Immediately after unilateral loss of vestibular function there are very dramatic symptoms – rapid eye movements (nystagmus), vertigo, nausea, ataxia, a tendency to fall to the affected side – the patient is incapacitated. These symptoms usually rapidly disappear so that most patients return to their normal lifestyle within some weeks or months. The term used to describe this overall recovery of function is ‘vestibular compensation’ and it appears to be a simple general improvement. Closer examination shows a different picture. This chapter is not a review but an overview, an integration, and it aims to provide some principles and insights in this very complex area to position the reader so they can understand and place into context the multitude of papers which have been written on this important area. The vestibular system is a fundamental sensory system -the vestibular nuclei receive a host of sensory inputs, vestibular, visual, proprioceptive - and the neural output from the vestibular nuclei directly or indirectly impinges on many other systems – the vestibular nuclei are the hubs of multimodal integration. During compensation there are profound changes in the activity of neurons at the vestibular nuclei which receive not only vestibular input but input from a variety of other sources. One process which takes place rapidly is the rebalancing the neural activity between the two vestibular nuclei which is disrupted by the unilateral vestibular loss. Some of the changes in improved performance after the loss are due to new behaviours which, whilst very effective, can be so subtle that they are very hard to identify.

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