Office Evaluation of Vestibular Dysfunction

The vestibular labyrinths sense motion of oneself. Like vision, the sensation of self-motion is one of the primary senses. In fact, phylogenetically, the ability to sense motion developed long before vision, as exemplified by the statocyst of the jellyfish. Vestibular sensation in humans remains a primitive input insofar as it is usually unconscious and used mostly for reflex motor activity. The main targets of this input are centres in brainstem, cerebellum and spinal cord thalamus and cerebral cortex are minor destinations. Although the flow of vestibular signals is continuous, we become aware of them only during unusual stimuli or when they conflict with other senses that supply motion information, especially vision. It is not surprising that a disturbance of this elemental input often arouses inordinateanxiety and causes symptoms that defy description