Phantom vestibular perception: Unfeasible or unnoticed?

Abstract

Objective: Phantom percepts frequently accompany the loss or damage of body parts or sensation, and have been described for virtually everything except for the vestibular system. Is it possible that phantom vestibular percepts exist and explain some cases of chronic dizziness, or is there something unique to the vestibular system that forbids this? Study design: This review surveyed the literature for any references to phantom vestibular perceptions. This was followed by a broader survey of phantom phenomena. Areas of focus were hearing, the limbs, and vision, and these were theoretically related to the vestibular system. Results: There apparently are no references to vestibular phantoms. There is robust research on tinnitus, phantom limb syndrome, and phantom eye syndrome. There are similar features and proposed aetiological models among these syndromes. Conclusion: It is within reason that vestibular phantom percepts exist, but to date have gone unnoticed due to the subjective nature of vestibular symptoms. However, the vestibular system is unique in several ways that may make phantom percepts far less likely than with other sensory systems. In particular, the cerebral cortex does not have any areas with exclusively vestibular input. In addition, the brainstem processes bilateral vestibular inputs in a unique push-pull mechanism, and synaptic plasticity in the vestibular nucleus facilitates compensation from vestibular injuries. In addition, unlike other senses, there is no conscious perception of vestibular laterality (i.e. which side is injured). This intriguing concept is challenging to prove.