November 09, 2023

Dizziness due to Visual Vertigo, Motion Sensitivity, and Mal de Debarquement Syndrome (And How to Treat It)

Normally, the human balance system incorporates information from vision, inner ear vestibular system, and the proprioceptive system. The inner ear vestibular system is responsible for detecting rotational and linear movements of the head whereas the proprioceptive system is responsible for knowing where one's body and limbs are positioned from information provided by the skin, muscles, joints. Vision provides information on where one is in space relative to other objects.

Normal balance requires the brain to incorporate information from all 3 systems which is then synthesized into "normal" balance sensory output.

Of course, if any of these systems are dysfunctional, dizziness occurs. For example, BPPV is a dysfunction of the inner ear vestibular system leading to sudden transient spinning attacks with head movement. Cervicogenic vertigo is due to dysfunction of the proprioceptive system that may occur from whiplash cervical injury. Visual dysfunction can lead to imbalance as occurs when a person is stumbling around at night.

As opposed to the prior examples, visual vertigo, motion sensitivity, and mal de debarquement syndrome are actually to a dysfunction of the brain. Vision, inner ear, and proprioceptive systems are all working normally and testing of these different system individually alone will all come back normal.

What happens in these particular disorders is that the brain is over-emphasizing input from the visual system while ignoring data coming in from the other 2 systems. Given the lopsided emphasis on vision, dizziness occurs. Even people with normal balance will experience this for a transient time when watching a point-of-view roller coaster on a large screen. Movement will be felt due to the eyes deceiving the brain which ignores input from the inner ear and proprioceptive systems which state that no movement is present. However, unlike normal individuals, people suffering from visual vertigo, motion sensitivity, and mal de debarquement syndrome will continue to have recurrent or prolonged symptoms even to minimal triggering events.

Thankfully, there are relatively simple home exercises that one can perform to help the brain "reset" back to normal and regain normal balance with proper synthesis of input from the 3 different systems.

Check out the videos shown here on how to perform these exercises!

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

Banner Map

Pediatric Neck Masses

Adult Neck Mass Workup