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Tight muscles can even contribute to and cause pain in the posterior area of the vestibule. People with hypertonic pelvic floor dysfunction may experience urinary symptoms like urgency and/or symptoms like constipation, rectal fissures, hip pain, and/or lower back pain. [10] Pain extending outside of the vulvar vestibule may have other sources.
Problems with balance can occur when there is a disruption in any of the vestibular, visual, or proprioceptive systems. Abnormalities in balance function may indicate a wide range of pathologies from causes like inner ear disorders, low blood pressure, brain tumors, and brain injury including stroke.
The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and vestibular neuritis. [1] [2] Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears.
Vestibulopathies are disorders of the inner ear. They may include bilateral vestibulopathy, [1] central vestibulopathy, [2] post traumatic vestibulopathy, [3] peripheral vestibulopathy, [4] recurrent vestibulopathy, [5] visual vestibulopathy, [6] and neurotoxic vestibulopathy, [7] among others. Tinnitus is a common vestibulopathy.
Cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS) is an autosomal recessive late-onset heredodegenerative multisystem neurological disease. The symptoms include poor balance and difficulty walking. Chronic cough and difficulty swallowing may also be present.
Benign paroxysmal positional vertigo (BPPV) is a disorder arising from a problem in the inner ear. [3] Symptoms are repeated, brief periods of vertigo with movement, characterized by a spinning sensation upon changes in the position of the head. [1] This can occur with turning in bed or changing position. [3]
Neurologic disorders tend to cause constant vertigo or disequilibrium and usually have other symptoms of neurologic dysfunction associated with the vertigo. Many medications used to treat seizures, depression, anxiety, and pain affect the vestibular system and the central nervous system which can cause the symptom of disequilibrium. [21]
A review of symptoms, a medical history, and a physical examination or vestibular tests in a rotary chair are needed to make the diagnosis. There are several different causes of bilateral vestibulopathy, including gentamicin toxicity, but the rotary chair test will determine the effects on both ears.