Panic Attacks & Cerebellar-Vestibular Dysfunciton (Huh?)

This may surprise you; however, pivotal to any discussion of the biology of panic attacks is the inner ear; home of our ability to hear and, for the purposes of this particular chat, our balance and equilibrium headquarters. No doubt, this consideration doesn’t get as much press as other biological triggers of panic, so tune-in.

Okay, then – we’re going to need to discuss a wee-bit of anatomy here, so hang with me. Within the extremely complex environment of the inner ear is a tad of fluid-filled (endolymph) anatomy known as the membranous labyrinth, the largest part of which floats in a fluid called perilymph. Now, all of this is contained in a structure known as the bony labyrinth. Are you with me?

Within the membranous labyrinth is a relatively large area known as the vestibule, which contains two connected sacks. One of these sacks, the utriculus, is the principal organ of what is known as the vestibular system. In its efforts to maintain balance and equilibrium, the vestibular system receives and integrates information from the eyes, ears, and muscles of the trunk, neck, and limbs. One of the major communication conduits employed is the brain’s cerebellum, which – no surprise - plays a huge role in the integration of sensory perception, as well as motor control. Now, that wasn’t too bad, was it?

Disorders of the vestibular system can cause all sorts of mental, emotional, and physical problems, including panic attacks and anxiety. For example, chronic anxiety is a common side effect of labyrinthitis, an inflammation of the inner ear labyrinths; and a panic attack may, indeed, be one of the first signs of the onset of infection. So it’s fact, and it’s significant, that labyrinthitis, a dysfunction of the vestibular system, can cause panic.

Turning the tables, research has shown that vestibular system dysfunction may actually occur as a result of anxiety. Go figure. Panic seen within the context of vestibular system dysfunction may well be triggered by any number of physiological processes that merit examination; however, the most significant trigger is the misinterpretation of, and overreaction to, the unpleasant symptoms it produces.

As we take a look at these symptoms, I don’t think you’ll find it difficult to envision yourself panicking in their presence; especially if you had no idea as to why the symptoms were presenting. Here are just a few: dizziness, loss of balance, increased physiological responses to stress and anxiety, motion sickness, headache, attention and focus issues, tinnitus (a ringing or high-pitched buzzing noise), trouble focusing and tracking with the eyes, distorted hearing, confusion, and loss of memory. Think those would make you edgy?

It all makes perfect sense to me. Anything causing abnormal and unpleasant sensations, or feelings of altered consciousness, is a breeding ground for panic attacks. Certainly, symptoms such as these would present problems for any panic sufferer, or for anyone predisposed to panic.

So, cerebellar-vestibular dysfunction. Perhaps you’d not considered it as it applies to panic attacks, but I’m thinking you may want to give it some thought. n