Bilateral vestibular weakness (BVW) is a rare cause of imbalance. Patients with BVW complain of oscillopsia. In approximately half of the patients with BVW, the cause remains undetermined; in the remainder, the most common etiology by far is gentamicin ototoxicity, followed by much rarer entities such as autoimmune inner ear disease, meningitis, bilateral Ménière’s disease, bilateral vestibular neuritis, and bilateral vestibular schwannomas. While a number of bedside tests may raise the suspicion of BVW, the diagnosis should be confirmed by rotatory chair testing. Treatment of BVW is largely supportive. Medications with the unintended effect of vestibular suppression should be avoided.

Bilateral vestibular loss is a rare cause of visual disturbance (oscillopsia) and imbalance. When severe, the most common cause is iatrogenic-gentamicin ototoxicity. Bilateral loss is easily diagnosed at the bedside with the dynamic illegible E test. If this test is omitted, it can easily be misdiagnosed as a cerebellar syndrome. Treatment is largely supportive. Care should be taken to avoid medications that suppress vestibular function, and to encourage activity.

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A monaural sound stimulus elicits a robust and reproducible surface myogenic potential in triceps muscles.

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Introduction Vestibular disorders (VDs) are highly prevalent in primary care. Although in general they comprise conditions that are not life-threatening, they are associated with significant functional and physical disability. However, the current coronavirus disease 2019 (COVID-19) pandemic has imposed limitations on the standard treatment of benign conditions, including VDs. In this context, other resources may aid in the diagnosis and management of patients with VDs. It is well known that teleconsultation and teletreatment are both safe and effective alternatives to manage a variety of conditions, and we maintain that VDs should be among these. Objective To develop a preliminary model of clinical guidelines for the evaluation by teleconsultation of patients with suspected diagnosis of vestibular hypofunction during the COVID-19 pandemic and beyond. Methods A bibliographic review of the diagnostic feasibility in VDs by teleconsultation was carried out in the LILACS, SciELO, MEDLINE, and PubMed databases; books and specialized websites were also consulted. The legal, regulatory, and technical issues involving digital consultations were reviewed. Results We found 6 field studies published between 1990 and 2020 in which the efficiency of teleconsultations was observed in the contexts of epidemics and environmental disorders and disadvantageous geographical conditions. After reviewing them, we proposed a strategy to examine and address vestibular complaints related to vestibular hypofunction. Conclusion The creation of a digital vestibular management algorithm for the identification, counseling, initial intervention, monitoring and targeting of people with possible vestibular hypofunction seems to be feasible, and it will provide a reasonable alternative to in-person evaluations during the COVID-19 pandemic and beyond.

Highlights Video head impulse testing and vestibular evoked myogenic potentials show that acute vestibular neuropathy is heterogeneous. Peripheral vestibular pathway vulnerability is approximately inversely correlated with its proportion of afferent fibers. Caloric testing, while useful, should no longer be considered the gold standard for diagnosing acute vestibular neuropathy.

It is arguable that no figure in Soviet lingui stics has had more influence on that and related disciplines than the Georgian linguist Nikolaj Jakovlevich Marr (in Georgian, Niko Iakobisdze Mari) ( 1864- 1934). This influence was so powerful and pervasive that its end was stipulated by no less a figure than Joseph Stalin, in no less a venue than a "debate on linguistics" held on the pages of Pravda in 1950. Marr's role in the development of Soviet linguistics, ethnology, and other disciplines has been the focus of numerous other works, and in this essay we will confine our attention primarily to the pre-Soviet Marr, attending to a series of often acrimonious disputes between Marr and his Georgian colleagues and students that marked the transition of his intellectual and political interestsfrom a parochial focus on Georgia and the Caucasus to a far wider purview. In this transition, Marr's increasingly antagonistic relationship with his Georgian students, coming to a head with the founding ofTbilisi State University in 19 18, plays a major role. We believe that the seeds of many crucial changes in Marr's theories were sown in this period, and our objective is to place Marr in his Georgian context.