Non-inflammatory lesions of the maze. Symptoms of vestibular disorders in cervical osteochondrosis

Equally important is the question of the relationship of angiovertebrogenic labyrinthopathies with other labyrinthopathies of unknown etiology, included by V. S. Olisov and V. G. Bazarov in the so-called non-inflammatory diseases of the labyrinth. According to V. S. Olisov, cervical osteochondrosis and other angiovertebral factors can cause the occurrence of Meniere’s disease.

If we add about a dozen other possible causes (menopause, hypertension, toxicosis, etc.) to this, the following question arises: can an independent nosological form (for which Meniere’s disease “claims”) have so many diverse causes?

And if we analyze the main hypotheses of the pathogenesis of Meniere’s disease (hypotheses of hydrops, insufficient resorption, “toxic”, thrombogenetic, embryogenetic, etc.), then the idea of ​​this disease as an independent nosological unit is completely lost. Probably, Meniere’s disease as such does not exist, but there is a symptom complex, characterized by the relative constancy of its phenomenology and the presence of a close anatomical and functional relationship between the vestibular and cochlear structures.

The most diverse causes (vascular, hydrodynamic and metabolic processes in these structures) can be triggering mechanisms for breaking existing relationships. The classical triad of symptoms in Meniere’s disease can be considered no more than a static combination of conditions that form this particular clinical picture, which are determined by the anatomical and topographic and functional features and maze constants. Simply put, directly in the labyrinth of a different picture (of course, with various variations) cannot arise, even with the greatest variety of etiological factors.

We find partial confirmation of this in the section of the monograph by I. B. Soldatov and co-authors, “Vestibular Dysfunction”, relating to Meniere’s disease. In addition to their desire, the authors debunk the thesis of the existence of a “disease” and state the thesis of the existence of a syndrome.

Symptoms of vestibular disorders in cervical osteochondrosis

Symptoms of vestibular disorders in cervical osteochondrosis are determined by the form and stage of the pathological process in the cervical spine or in the vertebral arteries themselves. Among the various types of pathology that are localized in the neck, A. V. Zhukovich, using data from various authors, distinguishes the following: traumatic injuries of the spine and spinal cord; cervical osteochondrosis; abnormalities of the styloid processes; tuberculous spondylitis; rheumatoid arthritis with involvement in the pathological process of the cervical spine; sympathetic ganglioneuritis; craniospinal abnormalities, etc.

In all these conditions, the labyrinth pathological response, if it occurs, is as if universal in nature, manifesting with typical cochlear and vestibular symptoms. Differences in signs of dysfunction of the inner ear, recorded by special methods, are most often caused by the phase state of the pathophysical process (N. S. Blagoveshchenskaya). In the vestibular system, phase states are most pronounced due to the fact that, unlike other analyzers, this system has inherent iolifunctional dependencies due to processes of interaction with sensory, motor, autonomic-endocrine and other areas.

Different degrees of severity of the same disease, having a different effect on labyrinth-dependent structures, can cause various phase states – from mild sensory aura to severe dizziness and severe vegetative syndrome. The persistence or temporary nature of the primary pathogenetic factor (for example, occlusion of the vertebral artery as a result of its thrombosis or transient irritation of its sympathetic plexus with bone growths) cause clinical syndromes that are different in form (but not in content!), Having their own course and its consequences.

However, in all cases, the vestibular syndrome is characterized by spontaneous sensory, motor and autonomic reactions. If any reactions occur, this does not mean that they do not exist at all, they are either unavailable for registration (the threshold of the method is higher than their manifestation), or in this phase state they have not yet manifested, or have already passed.

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