Managing an acoustic neuroma with vestibular rehab

You likely already know that vestibular rehabilitation is most commonly used to treat dizziness and balance issues related to vertigo, specifically Benign Paroxysmal Positional Vertigo (BPPV). However, vestibular rehab is also an effective treatment for those suffering from cranial tumors, specifically an acoustic neuroma.

An acoustic neuroma (AKA vestibular schwannoma) is a non-malignant tumor that can interfere with the nerves carrying hearing and balance information from the inner ears to the brain. It’s the third most common tumor in the brain, but it’s usually noticed fairly quickly due to the symptoms.

Acoustic Neuroma and dizziness

Usually, the first thing one will notice if they have an acoustic neuroma is a slowly progressing one-sided hearing loss or tinnitus, with a sense of dizziness and imbalance coming later (this can happen in reverse-order depending on what nerve fibers are being compressed). Blurry vision or sensitivity to busy visual environments can accompany too.

Not everyone will experience these symptoms right away, only encountering dizziness, balance, and vision issues (collectively referred to as vestibular symptoms) after they’ve treated or removed the tumor.

Why are the vestibular symptoms typically so limited? Well, an acoustic neuroma is usually a slow-growing tumor, and our brains have a remarkable ability to compensate for reduced vestibular information coming from one inner ear. The slowly declining vestibular input gives the brain lots of time to figure out how to compensate to keep symptoms at a minimum.

It’s only when surgery removes the tumor that the vestibular information coming in has a sudden change, making it harder for the brain to compensate, causing symptoms to appear. If undergoing a radiation treatment, the symptoms can appear months afterwards as those cells die off.

Vestibular rehabilitation is a key part of recovery

For those with vestibular symptoms, vestibular rehabilitation can be a very important part of symptom management and recovery. Following a thorough assessment by a vestibular therapist, they can develop a customized treatment program to help the brain re-establish vestibular information input.

Once the brain is operating accurately, it can do a better job of telling the muscles how to maintain balance and telling the eyes how to stay focused while the head moves.

Depending on one’s challenges, some of the vestibular treatment techniques can include:

• Keeping balance with eyes closed
• Walking while moving the eyes and head
• Watching objects in motion with busy backgrounds
• Repeatedly performing a motion that brings on dizziness so that the brain can habituate to it

The vestibular therapist can also address secondary complications that can result from a vestibular disorder, like nausea, concentration issues, fatigue, anxiety, and more.

Vestibular rehabilitation works best when there’s a stable (unchanging) deficit that the brain is trying to compensate for. If the tumor is continuing to grow, vestibular issues can change, making the vestibular rehab process more like trying to catch a moving target.

Once the tumor is gone, vestibular treatments should eventually minimize or eliminate symptoms

Sometimes people can experience a re-occurrence of symptoms long after recovery, known as decompensation. This can be triggered by a stressful physical/emotional event, a new vestibular issue or medical condition, or new medication, etc. It’s important to get re-assessed when this happens and tackle vestibular issues as they appear.

Lifemark’s robust Vestibular Rehabilitation program can help to manage symptoms that result from an acoustic neuroma or any other vestibular issues. Find a location near you across Canada and get assessed!