What is Vestibular Decompensation?

What is Vestibular Decompensation?

Vestibular compensation is the brain’s natural process of adapting to and recovering from a vestibular or inner ear disturbance, such as labyrinthitis or vestibular neuronitis, in order to minimise symptoms and regain balance control.

Vestibular decompensation refers to a condition when this process fails or weakens leading to a return or worsening of symptoms like dizziness, vertigo, imbalance and nausea. It typically occurs after a person has previously adapted to a vestibular issue but then experiences a setback due to various factors such as:

• Stress and fatigue
• Illness or infection
• Aging
• Head trauma or concussion
• Changes in medication
• Re-exposure to motion triggers such as car rides, boat travel.

Common symptoms of vestibular decompensation include:

• Increased dizziness or light-headedness
• Unsteadiness or difficulty walking particularly in the dark or on uneven surfaces
• Feeling like you are tilting or swaying
• Blurred vision particularly when you are moving
• Increased sensitivity to busy environments like supermarkets
• Nausea, fatigue, headaches
• Anxiety and panic attacks

Vestibular Rehabilitation can help to promote and enhance vestibular compensation, particularly when natural compensation is not sufficient, by retraining the brain to process signals from the vestibular system and coordinate them with other sensory inputs. Three strategies are incorporated into a vestibular rehabilitation exercise programme, each targeting different aspects of vestibular compensation:

• Adaptation – retraining the brain to improve the coordination between head and eye movements
• Compensation – teaching the brain to use other sensory inputs to maintain balance
• Habituation – exposing the brain to repeated movements that trigger dizziness so that the brain becomes less sensitive to those movements over time.