Is it the Vestibulocochlear Nerve or the Upper Neck?

Posted in Balance Disorder on Oct 19, 2020

Vestibulocochlear nerve Symptoms

Disorders that affect the vestibulocochlear nerve are among the most physically disabling conditions known to humankind.

The vestibulocochlear nerve is the 8th cranial nerve (CN VIII) that transmits hearing and balance information from your ears.

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Disease or pathology of the vestibulocochlear nerve commonly manifests as three predominant symptoms:

 

  1. Hearing loss (or the opposite, hypersensitivity)
  2. Vertigo
  3. Tinnitus (or “ringing noise” in the ears)

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The degree of these symptoms can vary, 

Often, when people suspect they may have a problem with the vestibulocochlear nerve, they seek help from the GP, from an audiologist, or from a specialist such as an ENT or neurologist.

These vestibulocochlear nerve specialists usually perform a series of tests including audiology, CT, and MRI scans of your brain to role out conditions such as cancer, multiple sclerosis, bleeding infection, or neurodegenerative disease. 

When these tests show that there is physical damage to the vestibulocochlear nerve, these specialists may be able to prescribe a course of treatment that may involve hearing aids, audio dampeners, or other medications to treat the symptoms (depending on what they are).

However, for many people who are certain that there is a problem affecting the vestibulocochlear nerve, the tests all come back as being “normal.”

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How is that possible that you can experience hearing loss (or even its opposite, i.e., increased hearing sensitivity, aka hyperacusis), tinnitus, or vertigo?

Many people now spend all their time trying to get a diagnosis for their condition: Meniere’s disease, BPPV, labyrinthitis, vestibular neuritis, sensorineural hearing loss, somatosensory tinnitus, etc

The potential list of diagnoses that involve the vestibulocochlear nerve is huge! 

For all the possibilities, there is one question that may be most important able all else if you experience a vestibulocochlear nerve disorder: what is CAUSING the problem?

Because if you understand the cause of the problem, you don’t just have to treat the symptoms. You may be able to address the root of the problem so that you can achieve long term improvements with your health again!

Now, you might be wondering how this is possible for your CT and MRI and other tests have all shown that “everything is normal.”

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The answer may be because you do not have a pathological condition that is affecting your vestibulocochlear nerve. You may have a functional condition that affects the function of your nerves.

In addition, the problem may not actually be with your vestibulocochlear nerve at all. 

The problem could be coming from a mechanical issue in your upper neck.

 

What does it mean if my brain MRI is clear and the vestibulocochlear nerve is normal?

What is the difference between a pathological and functional condition? And how could a problem in the upper neck affect the vestibulocochlear nerve?

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Let’s use a metaphor involving your electronic kettle.

An example of a “pathological condition” would be rust, frayed wires, broken pieces, or other dings/dents in the kettle than you can see. If the damage is severe enough, any of these things could potentially affect your kettle.

Contrast these with a “functional condition” where there is no physical problem with the kettle itself … but that you simply don’t have the electrical stick turned on at the wall. Therefore, there is no power flowing to it.

So you see, you can have the same end-result, but two completely different ways of getting it. You can have physical damage that affects your kettle - a pathological condition - OR you could instead have a functional problem - no electricity - that both cause the same effect: that your kettle doesn’t work.

The same goes for the vestibulocochlear nerve or any other nerve in your body for that matter. You can have physical damage (which would be visible on CT or MRI scans) … OR you could instead have a functional problem where something else is affecting the function of the vestibulocochlear nerve.

One important possibility is that of a mechanical misalignment in your upper neck.

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Allow me to explain.

The top bones in your neck are called the C1 (atlas), C2 axis) and C3 vertebrae. These vertebrae are unique in the spine in that they contain thick ligaments called “myodural bridges” that anchor the bone onto your spinal cord. 

The purpose of these ligaments is to maintain the patency of your spinal canal so that your brainstem doesn’t get squished when you move your head. They also assist with the circulation of cerebrospinal fluid (CSF), which provides oxygen and energy for your brain.

Normally, these vertebrae sit in normal alignment with each other. However, if you have ever suffered an injury that affected the alignment or centre of gravity of either the C1, C2, or C3 vertebra, it is possible that the vertebrae have been knocked “off centre.”

 

There are a few potential consequences of such an injury.

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  1. The physical shifting in the [position of the bone could produce physical tension through the ligaments and onto the spinal cord, which affects its overall function. It takes only 2 grams worth of press (the weight of a 5c coin) to decrease the firing rate of a nerve by over 50% in just 15 minutes. In other words, even a tiny misalignment can have truly significant effects on the function of your nerves.

 

  1. The misalignment could congest CSF or normal blood flow to/from the brain, thereby potentially leading to numerous neurological problems up- or -downstream. Specifically, the arteries and veins that supply blood to the vestibulocochlear nerve transmits directly through the C1, C2, and C3 vertebrae, and thus may be subject to disruption.

 

  1. The injured joint nerve receptors may bombard your brain with “danger” signals about pain, pressure, or proprioception (i.e., balance). If these noxious signals overwhelm your brain’s processing circuits, the information may produce a number of abnormal signals that could produce the same types of symptoms as a vestibulocochlear nerve issue.

 

That’s right! Many of the nerve receptors in your upper neck transmit to the exact same processing centres in your brain as the vestibulocochlear nerve. Therefore, an issue with the upper neck could possibly produce the same type of problem,

What kinds of injuries can cause problems with the alignment of the upper neck? Any significant head, neck, or whiplash injury could be responsible. And it doesn’t need to be a high-impact or even major collision either.

Whether there was blood or not, a physical injury at just the wrong angle may have been enough to cause a shift in the alignment of the C1, C2, or C3 vertebrae. Then, the accumulation of this damage - like unpaid interest on a car loan or mortgage - will begin to add up.

Many people attribute vestibulocochlear nerve issues as simple, “getting older.” Few things could be farther from the truth. If it were true, then 100% of ALL  people would experience hearing changes, vertigo, or tinnitus as they get older … and that simply is not the case.

Therefore, it means that there must be some other factor at work!

So if you have already had a series of vestibulocochlear nerve tests including audiology assessments, brain CTs and MRIs but no one can figure out what is going on or how to help you, here is where it may be valuable to have an assessment with an upper cervical chiropractic doctor.

 

What is an Upper Cervical Chiropractic Doctor?

Upper cervical care is a special division of chiropractic that focuses on the alignment and function of the top vertebrae in the neck - C1, C2, and C3 - and how they can affect the nervous system. An upper cervical chiropractic doctor will have completed advanced training beyond the standard university degree.

At the ting of writing hits article, in Australia, there are only approximately 15-20 certified practitioners using this work. No wonder you may never have heard of it before!

Unlike general spinal manipulation, there is NO neck twisting, cracking or popping. Everything that an Upper Cervical chiropractic doctor does is focused on precision and quality for achieving the greatest probability for a positive outcome.

The general process that an upper cervical chiropractic doctor uses is threefold. 

First is a physical and neurological examination to identify if there is a mechanical problem with your upper neck that could be affecting your nerve system, and therefore mimicking a problem with the vestibulocochlear nerve.

These types of tests commonly involve a posture analysis (including bilateral weight distribution), tension testing, static and motion palpation, and also infrared paraspinal thermography.

If these tests indicate that there is a problem in your upper neck, the next step is a series of three-dimensional x-rays taken at customised angles in order to see the alignment of the individual joints through your neck.

These types of tests are not performed in standard medical or chiropractic offices, which may be why so many of these types of problems are not diagnosed.

Once the problem is identified, the third step is a recommendation of care. It is impossible to predict exactly how much care you may need if you have a functional condition affecting your nerves and resembling a vestibulocochlear nerve problem.

If there is any principle that I can offer, it is that no matter what you have going on, you must be improving within 3-months of starting care.

Longer than that, you may be doing the right thing … but in the wrong order, like mixing the numbers in a combination lock. Shorter than that maybe isn’t giving things a fair go. So there is a fine line and balance between the two. Your upper cervical chiropractic doctor will be able to advise the level of care that is right for you based on the nature of your condition.

It is also important for me to explain that upper cervical care is not actually a treatment for the symptoms of a vestibulocochlear nerve problem. One major reason is that if your symptoms are related to a problem in your upper neck, it isn’t actually the vestibulocochlear nerve that is the issue!

Even more important is that is NOT how upper cervical care, or really any form of healthcare works. The way that upper cervical care works are by making a precise correction to the alignment of your upper neck if it is believed that it is affecting the function of your nerve system.

If this potential source of interference is corrected, the premise of upper cervical care is that your body will do what it naturally does: heal itself.

So you see, neither you (nor I) have the direct control over how your body heals itself. Nevertheless, if do we expect a favourable outcome given the chance? Yes.

 

 

The Second Step - Atlas Chiropractor Brisbane

We hope that you have found this article to be both informative and valuable.

That is the first step.

The second step if you are experiencing a condition that seems to involve the vestibulocochlear nerve, but your audiometry, CT, and MRI scans have all shown that “things are normal” is that we would like to hear from you.

If you are experiencing a vestibulocochlear nerve condition - no matter what the name of your diagnosis may be - and would like more information about how upper cervical chiropractic care may be able to help you, we would be happy to assist.

Our practice, Atlas Health, is the premier upper cervical health centre in Australia. Our mission is helping people with chronic health challenges - especially those cases where all the normal tests have been “normal” but people are still experiencing issues sure as vertigo, dizziness, migraines, headaches, neck pain, TMJ problems, and chronic pain disorders- so that they can get back o enjoying the quality of life that they desire most.

Our practice is located in north Brisbane (North Lakes) to service the greater Brisbane and Sunshine Coast communities. We are also conveniently located only 30 minutes from Brisbane airport to provide care for people from across Queensland, Australia, and internationally.

Our principal chiropractor, Dr. Jeffrey Hannah, is an Advanced Certified Blair Upper Cervical chiropractor. He is an international lecturer, speaker, author, and recognised leader in the field of upper cervical care globally.

If you would like to schedule a complimentary 15-minute over the phone consultation to speak with Dr. Hannah so that you can discuss your condition and so that you can decide if care might be right for you, we would be happy to arrange that for you.

To schedule a no-obligation consultation, you can reach our office at 07 3188 9329, or click the Contact Us, and one of our staff with a reply to your email as soon as possible.

We look forward to hearing from you and will do our best to assist you.

Atlas Health Australia - ‘Hope, healing and wellbeing from above-down, inside-out.”

 

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Lelic D, Niazi IK, Holt K, et al. Manipulation of Dysfunctional Spinal Joints Affects Sensorimotor Integration in the Prefrontal Cortex: A Brain Source Localization Study. Neural Plast. 2016;2016:3704964. doi:10.1155/2016/3704964. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800094/

Michiels S, De Hertogh W, Truijen S, Van de Heyning P. Cervical spine dysfunctions in patients with chronic subjective tinnitus. Otol Neurotol. 2015 Apr;36(4):741-5. doi: 10.1097/MAO.0000000000000670. https://www.ncbi.nlm.nih.gov/pubmed/25415466

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Rosa S, Baird JW. The craniocervical junction: observations regarding the relationship between misalignment, obstruction of cerebrospinal fluid flow, cerebellar tonsillar ectopia, and image-guided correction. Smith FW, Dworkin JS (eds): The Craniocervical Syndrome and MRI. Basel, Karger, 2015, pp 48-66 (DOI:10.1159/000365470).

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