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CANVAS Syndrome is named with an easy-to-remember acronym for cerebellar ataxia, neuropathy, and vestibular areflexia. There are only a very few patients reported who have the requisite combination of two rare clinical findings (cerebellar ataxia and vestibular areflexia), and the very common peripheral neuropathy. Patients with CANVAS combine cerebellar ataxia (i.e. coordination problems — the CA), peripheral nerve damage (neuropathy – N), and loss of vestibular function (vestibular areflexia — the VA). This combination causes major disturbances to balance as each of these systems alone contributes to balance. Of course, when all are out at the same time, balance is much worse than when only one or two happens to be malfunctioning.

WHAT IS CENTRAL NEUROTOXIC VESTIBULOPATHY? Central neurotoxic vestibulopathy is a poisoning of certain cells called neurons that help control balance by receiving and processing information from the inner ear vestibular sense organs (the semicircular canals,

Reduction or loss of vestibular function bilaterally results in difficulty maintaining balance, especially when walking in the dark or on uneven surfaces, and in a decrease in the patient’s ability to see clearly during head movements. In addition, patients with bilateral vestibular hypofunction or loss (BVH or BVL) also complain of intense feelings of being off-balance and of strange but disturbing sensations in their heads with head movement. Because of these problems, patients with BVH may restrict their activities and can become socially isolated.

Primary Complaints include:
– Balance and Risk for Falling
– Oscillopsia (visual blurring that occurs during head movements)
– Sense of Disequilibrium, Imbalance, and Dizziness
– Physical Deconditioning

Vestibular rehabilitation can improve postural stability, decrease the sense of disequilibrium, and improve visual acuity during head movements enabling people with BVH to resume a more normal life. Unfortunately, most patients have residual functional problems and subjective complaints. The exercises used for patients with BVL are aimed at fostering the substitution of alternative strategies to compensate for the lost vestibular function and at improving any remaining vestibular function.

PPPD symptoms include non-vertiginous dizziness and unsteadiness that is increased by a person’s own motion, exposure to environments with a complex or moving stimuli (e.g., stores, crowds), and performance of tasks that required precise visual focus (e.g., reading, using a computer). PPPD is NOT a psychiatric disorder, but rather a neuro-otologic condition with behavioral elements.

Symptoms from vestibular disorders are invisible and unpredictable. This does not mean that they are imaginary, but that they often contribute to a wide range of psychological impacts. People who have a vestibular disorder often need support and may benefit from counseling to cope with lifestyle changes, depression, guilt, and grief that comes from no longer being able to meet their own or others’ expectations.

Our vision tells us where we are in space and plays an important role in helping us maintain our balance. When our eyes are not functioning correctly and/or are not working together, vestibular symptoms can arise.

Some vestibular disorders may result in hearing problems, such as hearing loss, tinnitus (the perception of a constant ringing or other sound) and hyperacusis (sensitivity to sound).

Managing vision and hearing problems appropriately is part of an effective vestibular treatment plan.

The inner ear’s vestibular organs and the associated nerves and brain centers form a complex system that serve many functions and can be affected by a number of outside systems, such as vision and proprioception (i.e. your muscles and joints). A thorough evaluation of your vestibular function may involve:

– Medical history
– Physical examination
– Tests of inner ear function
– Hearing tests
– Balance tests
– Vision tests

Vestibular Impairment & Military Service While vestibular disorders can affect individuals of any age, background, or profession, military personnel are exposed to unique circumstances that can put them at risk for certain types of inner

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