Monday 2PM-6PM

INTRODUCTION

The following information will tell you about labyrinthine decompensation, a type of balance disorder. It is known by many other names, including unilateral vestibular weakness, and disuse dysequilibrium being two examples.

WHAT ARE THE SYMPTOMS OF DECOMPENSATION?

People with decompensation complain of problems with their balance, and this affects many aspects of their lives. They often complain of some, or all, of the following symptoms:

- Patients feel unsteady for a lot of the time. Often they feel as if they are going to fall over, and sometimes do.

- When turning the head patients sometime feel as if the world ‘is left behind’ and takes a split second to catch up with them.

- The feeling of imbalance is almost always worse in the dark, or when walking on an uneven surface.

- Being inside large spaces such as supermarkets, shopping malls or hangars can cause quite sudden disorientation.

WHAT CAUSES DECOMPENSATION?

Most patients with decompensation have had an episode of vertigo at some stage in their life, often years before their decompensation symptoms bother them.

In this sense, vertigo means an episode of dizziness. In patients with decompensation, they have often had vertigo lasting for a few days, during which they were confined to bed. This is called labyrinthitis.

When someone has labyrinthitis, one of their balance organs stops working for a short period of time, usually due to a virus infection. Your brain is used to getting messages from your balance organ telling it how your head is moving, so when one of the balance organs stops working your brain gets confused, and you feel dizzy. In most people your brain learns about the new situation within a couple of weeks, and the dizziness stops.

Sometimes, often a long time later, for reasons unknown your brain ‘unlearns’, or decompensates, and the dizziness returns, although not usually with a spinning sensation. The period of decompensation can be triggered by a life-event such as moving house or divorce. It can also be triggered by being unwell for other reasons.

ARE ANY SPECIAL TESTS NECESSARY?

In most patients with decompensation the diagnosis is clear-cut, and no further special tests are necessary. Sometimes, though, your specialist may request a scan of your brain, an MRI, to see if there is any reason that caused you to decompensate.

WHAT TREATMENT IS AVAILABLE FOR DECOMPENSATION?

The mainstay of treatment for decompensation is physiotherapy. Since the reason you have decompensated is because your brain has ‘unlearned’ how to cope with a defective balance organ, the treatment involves ‘re-educating’ your balance system.

This is covered in more detail in the Balance Exercises section.

There is no medication that will help in the treatment of decompensation. You may be on medication to stop you feeling dizzy, and may have been on it for a long time. The problem with these drugs is that they suppress the messages from your balance organs, which is why they work, but they stop your brain from re-learning, so tend to make patients worse in the long run. If you are taking this type of medication, your specialist will request that you stop taking it as a part of your treatment.

There are no operations that can help in the treatment of decompensation.

WHAT IS THE OUTLOOK FOR THE FUTURE?

Most people with decompensation do very well with the balance exercises, and can get back to a normal life fairly quickly.