Vestibular disorders are linked to distortions in own-body representations beyond known deficits in balance and spatial cognition. A study of 60 patients with dizziness found that 12% experienced distorted body size perceptions (hands or feet feeling larger or smaller), 37% reported abnormal sense of agency, 35% reported disownership for the body, and 22% reported disembodiment, all at higher rates than in healthy controls. A second experiment using caloric vestibular stimulation in healthy volunteers showed that left-warm/right-cold stimulation specifically increased the perceived length of the dorsum of both hands. The findings indicate a vestibular contribution to how the body is represented.
Out-of-body experiences (OBEs), where awareness feels located outside the physical body, occur in epilepsy, migraine, and depersonalization, and are not uncommon in the general population. Current models link OBEs to a failure to integrate visual, somatosensory, and vestibular signals, particularly visual-vestibular mismatch. This prospective observational study of 210 patients with dizziness and 210 matched healthy controls found significantly higher OBE occurrence in dizzy patients (14%) than controls (5%). Most patients first experienced OBEs after dizziness onset, primarily linked to peripheral vestibular disorders. Depersonalization-derealization, depression, anxiety, and migraine predicted OBEs in patients; depersonalization-derealization alone predicted OBEs in controls. OBEs in dizziness likely arise from perceptual incoherence from vestibular dysfunction combined with psychological and neurological factors.