Vertigo pathophysiology: Difference between revisions
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*The neurochemistry of vertigo includes 6 primary [[neurotransmitter]]s that have been identified between the 3-neuron arc that drives the [[vestibulo-ocular reflex]] (VOR). Many others play more minor roles. | *The neurochemistry of vertigo includes 6 primary [[neurotransmitter]]s that have been identified between the 3-neuron arc that drives the [[vestibulo-ocular reflex]] (VOR). Many others play more minor roles. | ||
*Three neurotransmitters that work peripherally and centrally include | *Three neurotransmitters that work peripherally and centrally include: | ||
**[[ | **[[Glutamate]] maintains the resting discharge of the central vestibular [[neurons]], and may modulate [[chemical synapse|synaptic transmission]] in all 3 neurons of the [[vestibulo-ocular reflex]] system. | ||
**[[Acetylcholine]] appears to function as an excitatory [[neurotransmitter]]. | |||
**Acetylcholine appears to function as an excitatory neurotransmitter | **[[GABA]] is thought to be inhibitory for the commissures of the [[medial vestibular nucleus]], the connections between the [[cerebellar]] [[purkinje cells]] and the lateral vestibular nucleus, and the vertical VOR. | ||
**GABA is thought to be inhibitory for the commissures of the medial vestibular nucleus, the connections between the cerebellar [[ | |||
*Three other neurotransmitters work centrally. | *Three other neurotransmitters work centrally. | ||
**[[Dopamine]] may accelerate vestibular compensation. | **[[Dopamine]] may accelerate vestibular compensation. | ||
Revision as of 18:58, 6 January 2021
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Vertigo Microchapters |
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Vertigo pathophysiology On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pathophysiology
- The neurochemistry of vertigo includes 6 primary neurotransmitters that have been identified between the 3-neuron arc that drives the vestibulo-ocular reflex (VOR). Many others play more minor roles.
- Three neurotransmitters that work peripherally and centrally include:
- Glutamate maintains the resting discharge of the central vestibular neurons, and may modulate synaptic transmission in all 3 neurons of the vestibulo-ocular reflex system.
- Acetylcholine appears to function as an excitatory neurotransmitter.
- GABA is thought to be inhibitory for the commissures of the medial vestibular nucleus, the connections between the cerebellar purkinje cells and the lateral vestibular nucleus, and the vertical VOR.
- Three other neurotransmitters work centrally.
- Dopamine may accelerate vestibular compensation.
- Norepinephrine modulates the intensity of central reactions to vestibular stimulation and facilitates compensation.
- Histamine is present only centrally, but its role is unclear. It is known that centrally acting antihistamines modulate the symptoms of motion sickness.
- The neurochemistry of emesis overlaps with the neurochemistry of motion sickness and vertigo.
- Acetylcholine, histamine, and dopamine are excitatory neurotransmitters, working centrally on the control of emesis.
- GABA inhibits central emesis reflexes.
- Serotonin is involved in central and peripheral control of emesis but has little influence on vertigo and motion sickness.