Bilateral Vestibular Dysfunction

Abstract

Bilateral vestibular dysfunction (BVD) refers to hypofunction of the vestibular nerves or labyrinths on both sides. Patients with BVD present with dizziness, oscillopsia, and unsteadiness, mostly during locomotion, which worsen in darkness or on uneven ground. Although aminoglycoside ototoxicity, Meniere's disease, infection, and genetic disorders frequently cause BVD, the etiology remains undetermined in up to 50% of the patients. The diagnosis of BVD requires both symptoms and documentation of deficient vestibulo-ocular reflex function using head-impulse, bithermal caloric, and rotatory chair tests. Since various neurologic and systemic disorders may present with BVD, clinicians should be cautious not to overlook the symptoms and signs of central nervous system and systemic involvements. Vestibular rehabilitation, application of vibrotactile and auditory feedbacks, and vestibular prosthesis can aid the patients with BVD along with the correction of the underlying causes.

An exceptional case of bilateral vestibular areflexia complicating acute otitis media

“…The therapeutic management is delicate, vestibular reeducation occupies a primordial place. neuro ibromatosis type 2) [2,4,5]. Rarer entities such as neurosyphilis, super icial siderosis, neurosarcoidosis, congenital malformations of the vestibular end organs, head injuries and trauma, "cerebellar ataxia, neuropathy, vestibular are lexia syndrome (CANVAS)" can be listed as possible causes of BVA [2,4,5], and the etiology of these dysfunctions remains unknown in approximately 50% of cases [2,4,5].…”

“…The post-otitis infectious etiology of BVA is rare [2,4,5], and is seen mainly in the course of chronic otitis media [6]. Indeed, only three cases of otitis was found in the small Chinese series of 42 patients with bilateral vestibular weakness [4], but no case secondary to otitis was noted in Hain, et al series of 213 patients followed for BVP [2].…”

“…The management of BVA is delicate. Vestibular rehabilitation has an important role [2,5]. Bilateral vestibular involvement justi ies optokinetic stimulation.…”

“…The diagnosis of BVA is a real challenge for clinicians [4] because various systemic and neurologic diseases may present with bilateral vestibular loss [2,5].…”

Protective Effects of Deferoxamine on Vestibulotoxicity in Gentamicin-Induced Bilateral Vestibulopathy Rat Model

“…Numerous drugs and chemical substances are known to affect the cochlea, vestibule, or both (1). Bilateral vestibulopathy is a disabling disorder characterized by dizziness, oscillopsia, and unsteadiness mostly during locomotion due to hypofunction of the vestibular organs on both sides (2)(3)(4)(5). The most common etiology of bilateral vestibulopathy is ototoxicity due to aminoglycoside (AG) antibiotics, followed by Meniere's disease, infectious diseases, and genetic disorders (5).…”