Which parts of brain used for balance and hearing?

I’ve been reviweing what I know about MAV and I’m puzzled about which parts of the brain are affected. In particular I’m interested in that group of people who have MAV and also hearing loss due to nerve damage.

As I understand it, balance is controlled by the cerebellum & brain stem (which are underneath the brain). Meanwhile hearing is handled by the temporal lobe. See Brain Function | Centre for Neuro Skills

Presumably the vestibular nerve goes from the ear to the cerebellum and brain stem. And the auditory nerve goes from the ear to the temporal lobe. (Are these guesses right?) Well, that means there isn’t much of a close connection between the parts of the brain for balance and for hearing.

I’m confused! I thought I half understood this. Awww.

Is the connection between the two occurring in the closeness of the balance and hearing nerves where they start rather than in the brain where they terminate?

I used to think it was something to do with the vertebrobasilar artery. You can google images of this, very interesting.

Christine

I am far from an expert, but hearing and balance signals both travel along the 8th cranial nerve (the vestibulocochlear nerve) from the inner ear to the part of the brainstem called the pons.

Here is a good diagram of the inner ear (scroll down a little to see the diagram):

dizziness-and-balance.com/di … aring.html

And if you Google “cranial nerves”, you will find plenty of diagrams to see how the cranial nerves (most of them) hook into the brainstem.

The 8th cranial nerve itself does not continue beyond the pons, but the SIGNALS received from it travel via other structures into other parts of the brain–to the cerebellum, controlling balance, coordination, and timing; and to higher centers for processing hearing and balance signals. Here it gets very complex, far beyond my rudimentary knowledge.

The facial nerve (7th cranial nerve) runs right beside the 8th cranial nerve from the ear to the brainstem via the internal auditory canal (IAC), but they diverge otherwise. That’s why some disorders, such as an acoustic neuroma (which grows where the 7th and 8th nerves course alongside/bundled with each other in or near the IAC), can affect your facial muscles as well as your hearing and balance.

And that’s about all I know about that. :slight_smile:

Nancy

— Begin quote from “Nancy W”

I am far from an expert, but hearing and balance signals both travel along the 8th cranial nerve (the vestibulocochlear nerve) from the inner ear to the part of the brainstem called the pons…the facial nerve (7th cranial nerve) runs right beside the 8th cranial nerve from the ear to the brainstem via the internal auditory canal (IAC), but they diverge otherwise. That’s why some disorders, such as an acoustic neuroma (which grows where the 7th and 8th nerves course alongside/bundled with each other in or near the IAC), can affect your facial muscles as well as your hearing and balance…Nancy

— End quote

That’s very useful info Nancy. Thank you. I get unexplained facial sensations so your info about the 7th cranial nerve is very interesting to me.

I took a look at your story and am amazed at what you’ve been through. http://mvertigo.cloudapp.net/t/migraine-equivalent/208#p26218 There’s a great deal to learn from your story but one thing puzzles me and that is what was causing all those random neurological oddities you describe from Autumn 1999 onwards? (Including the “invisible insects” on your face which I can relate to). Did you form any ideas about what was happening to cause these oddities?

-Wexan

As far as balance goes, I believe that the vestibular nucleus complex is the site responsible for MAV and Chronic Subjective Dizziness.

Here is an article which articulates the role this VNC plays

http://xa.yimg.com/kq/groups/1920818/732495233/name/dizziness.pdf

Wexan: The facial (7th cranial) nerve controls facial MUSCLES, but facial SENSATION is controlled by the trigeminal (5th cranial) nerve.

So if you are having “invisible insects” on your face, or numbness, tingling, pain, odd temperature sensations, etc., that would be the trigeminal nerve. This is also the nerve that causes headache pain, I think.

Your question of whether I “formed any ideas” about what caused/causes my neurological oddities opens a can of worms. :slight_smile:

The sad truth is (as you’ve probably found out) that neurologists often cannot explain a person’s weird symptoms, or they aren’t interested in trying to.

One neuro initially all but told me I had MS, but later he took it back, and all subsequent doctors have essentially said I don’t. On the other hand, they never had any PLAUSIBLE explanations for my symptoms.

I finally, recently, concluded that I must have some teeny-tiny “benign” form of MS, though I would NEVER say that to a doctor. (Just like I had to diagnose myself with MAV, because no doctor EVER gave me ANY explanation for my dizziness that held up to scrutiny and testing.)

I concluded this because subjectively I fit the essential, basic, boiled-down definition of MS: damage to at least two different parts of the central nervous system separated in time, with no better explanation.

I have (minor) brainstem abnormality and spinal cord abnormality, though both are apparently only SENSORY in nature, to which the docs ascribe no importance. (If my major walking trouble–I can only go one or two blocks now–is due to the spinal cord, then it’s not merely sensory damage, but I truly don’t know why I can’t walk sustainedly anymore–it may be joints or muscles.)

The brainstem abnormality is proved by auditory brainstem response (ABR) testing as well as strange sensory symptoms. The spinal cord damage is proved by my long-standing Lhermitte’s–electric buzzing in my leg(s) when I bend my head down.

I have two red-flag symptoms for MS: Lhermitte’s and bilateral trigeminal neuralgia (one painful episode in 1999 but mostly painless shocks since then).

But since my reflexes, eyes, gait, and MRI show no signs of MS over many years, the doctors have no objective, specific findings for it and so they just call me a hypochondriac. (My MRIs had an increasing number of little white lesions, but they are not specifically MS-looking–could be from migraine and/or “small vessel disease.”)

So–objectively I don’t have MS; subjectively (that is, in my thinking), I do–but not “real” MS, just a little shadow version of it, perhaps. That is just my theory. Because there IS no other plausible theory. Other things have all been ruled out. But I do NOT meet the doctors’ definition for MS by a long shot (because they need objective physical evidence–though they ignore my ABR and MRI results).

They have tried to do a spinal tap to help rule it in or out, but they have been unable to withdraw spinal fluid. And there are other tests that they never did. But I accept that officially, practically, I don’t have MS.

I just use it as an explanation to settle my own mind, because otherwise I would keep being driven nuts by that buzzing every time I bend my head down, thinking “What IS it???”

I know you’ve had a long, hard time figuring out what’s wrong with you, too. What do you think about your own case?

Nancy

— Begin quote from “Nancy W”

I know you’ve had a long, hard time figuring out what’s wrong with you, too. What do you think about your own case?Nancy

— End quote

Nancy, thank you very much for your interesting reply. You have got a much more complex pattern of symptoms than I have but I do relate to a small subset of what you have described. I’ve written a lot of detail about my case below … so get a glass of water, take a deep breath and please see if what I have written here makes any sense to you or anyone else.

FACE FLICKERING. I experience some sort of twitchiness or mild flickering over much of my face and at those times I go into a sort of confusion. Last year this was at it’s worst (and also exacerbated by long lasting bouts of chest pain which I get) and then I couldn’t watch fast moving images on TV because they massively overwhelmed me. The chest pains were complicating the picture but now that they have improved I can see the remaining symptoms.

DIZZINESS AND CONFUSION. I get a bout of dizziness at least once a day which lasts for hours and affects my balance if I try to walk across the room or along the street. Occasionally I feel very distinctly as if I am walking on sponges. I don’t get any headache pain as such. However during these bouts I feel super-unwell and can go into confusion such that I can’t write properly or can’t work out how to take a shower. During a bout I am extraordinarily inattentive and can’t understand things happening around me or undertake simple tasks (such as using the washing machine or dialing a phone number). I could go on for ages about what other symptoms there are but suffice it to say it looks like I have had a bad mini-stroke. Sadly I don’t properly recover all my balance or visual function in between bouts. It is very like a state of clinical delirium but with the addition of balance and vision problems. Delirium - Wikipedia

CHEST PAIN. For the last couple of years I has wrongly been directing my doctors to look at my chest pains for the cause of my states of confusion because the chest pain I was experiencing seemed to be a cause of my dizziness. I have had many chest scans ordered by cardiologists, lung doctors and rheumatologists but nothing has been found. Very recently I have come to see that the chest pain is a separate thing and it’s not due to anything sinister; my current guess is it probably comes from a liver hemangioma I have got.

MISDIAGNOSIS. Initially this was misdiagnosed as early-onset Alzheimer’s dementia (I am 56 years old) but that has now been withdrawn. Unfortunately my insistence that my chest pains were indicating a cause has let to my neurologist to think this is one of those strange inexplicable neuro-psychiatric conditions. I saw my neurologist earlier this week and I have been suggested to undergo cognitive behavioural therapy. This is the book he suggested I look at. http://www.amazon.com/Overcoming-Unexplained-Neurological-Symptoms-Approach/dp/1444138340/ I just don’t think CBT is the answer although I am prepared to accept that it may help with improving any dysfunctional neurological “short-circuits” which may have occurred as a consequence of not getting treatment soon enough.

BENZODIAZEPINES. I used to take short-acting benzodiazepines (loprazolam or lormetazepam with a half life of 5 hours ) when I got into states of confusion because they helped a lot but I am not so severely ill now and I don’t think the benzos are anything like as helpful as they were when I was very ill. The benzos don’t seem to help with the face twitching but I may need to experiment a bit more to be certain of this. My neurologist (at the National Hospital for Neurology in London) thinks that the benzos might possibly be having an adverse effect and making me more vulnerable to these unexplained bouts, so he would like me to discontinue them as I now developed a tolerance over the years and need to take a benzo every night to sleep.

NEXT STEPS. I am not sure I have typical MAV but it does seem similar because some sort of neurological storm seems to come along and during those moments I get confused with visual and balance problems. In addition, like some people here I have unexplained one-sided hearing loss. What I can’t understand is why I am getting these bouts daily which seems very frequent. I would have guessed that I might be experiencing some sort of epilepsy but my bouts last too long. I have been a bit disappointed by my doctors and suspect that I will have to steer my own way to some extent.

So I’d be interested if you (or anyone else here) have any thoughts about my condition.

-Wexan