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Adaptation to vestibular disturbances: some clinical implications.

A knowledge of the mechanisms used in adaptation to vestibular lesions is important for both diagnostic and therapeutic purposes. Here we discuss commonly encountered circumstances--habitual wearing of spectacles, unilateral or bilateral labyrinthine dysfunction--that call for adaptation. The context specificity of vestibular adaptation is emphasized because of its crucial role in designing programs of physical therapy. The pharmacological manipulation of plasticity, either purposeful facilitation, or inadvertent retardation, is an area of current investigation of direct clinical importance. Finally, the wide range of adaptive responses and strategies available to participate in the compensatory process is emphasized, so that they can be marshalled together to optimize vision and balance.