Vestibular Nerve Damage: Symptoms and Travel Concerns

Q: Vestibular Nerve Damage: Symptoms and Travel Concerns

Hello, the responses to your questions are as follows： 1. Yes. 2. The function of the vestibular nerve may be impaired, but it can improve through compensation by the brain. Dizziness usually improves gradually, and flying should not have an impact. <b

Vestibular nerve deficiency

Hello Doctor: I was involved in a car accident last November, which resulted in subarachnoid hemorrhage, a closed skull fracture without intracranial injury, and facial contusions.
After one day of treatment and observation in the intensive care unit, I was transferred to a general ward for further observation, and I did not undergo any brain surgery.
About three months after discharge, I experienced dizziness whenever I made significant head movements, lay down to sleep, or got up.
Currently, the dizziness has improved, and I rarely feel dizzy.
On April 23 of this year, I underwent an inner ear function test in the otolaryngology department, which revealed a 20% deficit in the left vestibular nerve.
Additionally, about three months after discharge, I noticed my lower eyelid twitching when looking in the mirror.
The twitching sensation was subtle, but it was clearly visible in the mirror; however, I have since observed that the twitching has ceased.
I would like to ask the doctor: 1.
Does damage to the vestibular nerve mean there is impairment in the balance sense? 2.
With a 20% deficit in the vestibular nerve, will I still be able to fly, or is it unsuitable for me to fly? Could there be severe tinnitus or similar issues? Before the accident, I did not experience dizziness or discomfort while flying, and tinnitus was not noticeable.
3.
Additionally, was the eyelid twitching I experienced due to facial nerve dysfunction from the accident? Although it has stopped twitching now, is there a possibility of recurrence? What tests can be done for facial nerve dysfunction? Should I consult the otolaryngology department or neurosurgery? I appreciate your response, thank you!

gary, 20~29 year old female. Ask Date: 2015/10/14

Dr. Zheng Jueyi reply Otolaryngology

Hello, the responses to your questions are as follows:
1.
Yes.

2.
The function of the vestibular nerve may be impaired, but it can improve through compensation by the brain.
Dizziness usually improves gradually, and flying should not have an impact.

3.
In theory, facial nerve dysfunction caused by trauma typically occurs at the moment of the injury, and the chances of delayed onset are rare, so recurrence is unlikely.
Additionally, facial nerve twitching does not necessarily indicate facial nerve dysfunction; if it occurs frequently, a consultation with a neurologist for evaluation is recommended.

Wishing you peace and good health.

Sincerely,
Dr.
Jue-Yi Cheng,
Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2015/10/14

More Info

Hello,
Thank you for sharing your concerns regarding the vestibular nerve damage and its implications for your health and travel plans. I understand that you have been through a significant ordeal following your car accident, and it's important to address your questions thoroughly.

1. Vestibular Nerve Damage and Balance: Yes, damage to the vestibular nerve indeed affects your balance. The vestibular system, located in the inner ear, is crucial for maintaining equilibrium and spatial orientation. When there is a loss of function, such as the 20% deficit you mentioned, it can lead to symptoms like dizziness, imbalance, and vertigo, especially during head movements or changes in position. This is because the brain relies on signals from the vestibular system, along with visual and proprioceptive inputs, to maintain balance.
2. Traveling by Air with Vestibular Nerve Damage: Regarding your ability to fly, it is generally safe for individuals with vestibular nerve deficits to travel by air, but there are some considerations. The changes in cabin pressure during takeoff and landing can sometimes exacerbate symptoms of dizziness or ear discomfort, especially if you have a history of ear issues or if your vestibular function is compromised. While you may not have experienced significant problems before your accident, it is advisable to consult with your ENT specialist or a neurologist before flying. They can provide personalized advice based on your current condition and may recommend strategies to manage any potential symptoms, such as using nasal decongestants or performing specific maneuvers to equalize ear pressure.

3. Eye Lid Twitching and Facial Nerve Dysfunction: The eyelid twitching you experienced could indeed be related to facial nerve dysfunction, often referred to as "hemifacial spasm" or simply eyelid myokymia. This condition can occur due to stress, fatigue, or irritation of the facial nerve. Since you mentioned that the twitching has resolved, it may have been a temporary issue. However, if it recurs, it would be wise to consult a neurologist who specializes in facial nerve disorders. They can conduct a thorough examination and may suggest imaging studies, such as an MRI, to rule out any underlying causes.

In summary, while your vestibular nerve damage may pose some challenges, particularly regarding balance and potential dizziness during travel, it is generally manageable with proper medical guidance. As for the eyelid twitching, monitoring your symptoms and seeking further evaluation if they return is prudent.
I recommend keeping a close relationship with your healthcare providers, including your ENT and neurologist, to monitor your recovery and address any new symptoms that may arise. They can provide the most accurate assessments and tailored recommendations for your situation.

Wishing you a smooth recovery and safe travels in the future. If you have any further questions or concerns, please feel free to reach out.

Best regards.

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