Vestibular schwannoma surgery causes in majority of patients the unilateral peripheral or combined vestibular lesion due to surgical interruption of both branches of vestibular nerve. It manifests postoperatively with postural instability, vertigo, oscilopsia and even with vegetative symptoms. Central compensation, in which cerebellum plays dominant role, influences duration of the symptoms. Factors affecting compensation may be divided into several groups (general health status of a patient, the tumor itself, actual state of function of vestibular system, external factors induced by a therapeutist). Therapeutic aim is to induce compensatory mechanisms as soon as possible and to reduce overall duration of the compensation. The aim of this study is to consider predictive factors influencing central vestibular compensation and to influence the vestibular compensation itself. Early operated vestibular rehabilitation is a basic procedure. It leads to faster recovery in majority of patients. Even with maximal effort the full compensation is not always achieved. It results in permanent deficit of vestibular function manifested with postural instability. However in some patients it is difficult to achieve full compensation despite maximum effort of a physiotherapeutist and that results in permanent...

Seules deux structures du système nerveux central adulte, la zone sous-granulaire et la zone sous-ventriculaire, produisent continuellement de nouveaux neurones et sont considérées comme neurogènes. En dehors de ces zones délimitées, le tissu nerveux ne possède pas de telles facultés. Leurs influences anti-neurogènes peuvent cependant être mises entre parenthèses dans certaines conditions. Cela se produit après neurectomie vestibulaire unilatérale (NVU) chez le chat adulte ; en effet, des études immunohistochimiques et comportementales nous ont permis de découvrir l'existence d'une neurogenèse réactionnelle de type GABAergique dans les noyaux vestibulaires désafférentés situés dans le tronc cérébral. Nos résultats témoignent de l'implication fonctionnelle de cette prolifération cellulaire dans la restauration des fonctions posturo-locomotrices suite à une NVU. Nous avons également mis en évidence que les caractéristiques et l'intensité de la désafférentation vestibulaire déterminent, non seulement, le décours temporel de la restauration des fonctions vestibulaires, mais aussi les différents mécanismes cellulaires post-lésionnels et le potentiel neurogène des noyaux vestibulaires. En outre, nous avons démontré que l'activation ou le blocage des récepteurs GABA de type A influence d'une part, les différentes étapes de la neurogenèse réactionnelle dans les noyaux vestibulaires, et détermine d'autre part le décours de la récupération comportementale des animaux. Ainsi, le système GABAergique joue-t-il un rôle important dans la régulation de la neurogenèse induite après NVU et de sa fonctionnalité. / Only two structures of the adult central nervous system: the subgranular zone and the subventricular zone, produce continuously new neurons and are considered as neurogenic. Outside these two delimited areas, nervous tissue does not have such faculties. The anti-neurogenic influences can however be removed under specific conditions. That is what happens after unilateral vestibular neurectomy (UVN) in the adult cat: behavioral and immunohistochemical studies have demonstrated the existence of a reactive GABAergic neurogenesis in the deafferented vestibular nuclei located in the brainstem. Our results demonstrate the functional role of the vestibular cell proliferation in the postural locomotor function recovery after UVN. We also demonstrated that characteristics and intensity of the vestibular lesion, not only determine the time course of recovery of vestibular function, but also the post-lesional cellular mechanisms and the neurogenic potential occurring in the vestibular nuclei. In addition, we showed that activation or blockade of GABA type A receptors influences the different steps of neurogenesis in the vestibular nuclei, and also determines the time course of behavioral recovery. Thus, the GABAergic system influences reactive neurogenesis that is benefic for vestibular compensation process. Finally, the results of a recent study demonstrated that vestibular-hippocampal relations exist, and that stress induced by vestibular deafferentation can modulate adult neurogenesis in both the vestibular nuclei and the dentate gyrus in the adult cat.