Bilateral Idiopathic Loss of Peripheral Vestibular Function with Normal Hearing

Vibert, Dominique; Liard, P; Häusler, Rudolf

doi:10.3109/00016489509139375

Cited by 72 publications

(79 citation statements)

References 7 publications

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“…Complete recovery did not occur in any of the patients. 5 Improvement of vestibular function was also described in single cases of different aetiologies, 9 in particular when BV was caused by serous rather than suppurative destructive labyrinthitis. 4 10 11 In contrast, in a 5 year follow-up study 7 of seven patients with BV, Baloh et al did not find significant improvement in vestibular excitability.…”

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confidence: 98%

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Follow-up of vestibular function in bilateral vestibulopathy

Zingler

Weintz²,

Jahn³

et al. 2007

Akt Neurol

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Objective: Bilateral vestibulopathy (BV) leads to a bilateral deficit of the vestibulo-ocular reflex and has various aetiologies. The main goal of this study was to determine the frequency and degree of recovery or worsening of vestibular function over time. Methods: 82 patients (59 males, 23 females; mean age at the time of diagnosis 56.3 (SD 17.6) years) were reexamined 51 (36) months after the first examination. All patients underwent a standardised neuro-ophthalmological and neuro-otological examination. Electronystagmography with bithermal caloric irrigation was analysed by measurement of the mean peak slow phase velocity (SPV) of the induced nystagmus. Patients evaluated the course of their disease in terms of balance, gait unsteadiness and health related quality of life. Results: Statistical analysis of the mean peak SPV of caloric induced nystagmus revealed a non-significant worsening over time (initial mean peak SPV 3.0 (3.5)u/s vs 2.1 (2.8)u/s). With respect to subgroups of aetiology, only patients with BV due to meningitis exhibited an increasing, but non-significant SPV (1.0 (1.4)u/s vs 1.9 (1.6)u/s). Vestibular outcome was independent of age, gender, time course of manifestation and severity of BV. Single analysis of all patients showed that a substantial improvement >5u/s occurred in two patients on both sides (idiopathic n = 1, Sjögren's syndrome n = 1) and in eight patients on one side (idiopathic n = 6, meningitis n = 1, Menière's disease n = 1). In 84% of patients there was impairment of their health related quality of life (42% slight, 24% moderate, 18% severe). Forty-three per cent of patients rated the course of their disease as stable, 28% as worsened and 29% as improved. Conclusions: Our data support the view that more than 80% of patients with BV do not improve. Thus the prognosis of BV is less favourable than assumed.

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confidence: 98%

“…BV is a rare vestibular disorder of various aetiologies (eg, ototoxic drugs, meningitis or Menière's disease). [4][5][6] Despite intensive examinations, the aetiology remains unclear in approximately 50%. 6 Little is known about the course of the disease, especially the recovery.…”

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confidence: 99%

Follow-up of vestibular function in bilateral vestibulopathy

Zingler

Weintz²,

Jahn³

et al. 2007

Akt Neurol

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“…A ausência completa de resposta na prova calórica e ou na prova rotatória pendular decrescente é achado raro em pacientes com queixa de vertigem e desequilíbrio 1,10 . Essa baixa freqüência justifica a escassez de literatura sobre o assunto, o tamanho da nossa amostra, e a dificuldade de se conduzir ensaios clínicos prospectivos.…”

Section: Discussionunclassified

“…A perda bilateral da função vestibular periférica é rara em pacientes com queixa de vertigem e desequilíbrio, e representa 0,6% das eletronistagmografias 1 . As prováveis causas da AVB estão relacionadas ao uso de ototóxicos, traumas, meningite, infecção labiríntica, tumores bilaterais (schwanoma vestibular), otosclerose, hidropisia endolinfática, cirurgia otológica, doença auto-imune e idiopática 2,3 .…”

Section: Introductionunclassified

“…As prováveis causas da AVB estão relacionadas ao uso de ototóxicos, traumas, meningite, infecção labiríntica, tumores bilaterais (schwanoma vestibular), otosclerose, hidropisia endolinfática, cirurgia otológica, doença auto-imune e idiopática 2,3 . Dentre todas as etiologias citadas, a mais freqüente é a ototoxicidade, responsável por 21% dos casos 1 . Os principais sintomas descritos na AVB incluem a oscilopsia e o desequilíbrio.…”

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Arreflexia pós-calórica bilateral: aplicabilidade clínica da reabilitação vestibular

Bittar¹,

Bottino²,

Pedalini³

et al. 2004

Rev. Bras. Otorrinolaringol.

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Bilateral vestibular loss after caloric irrigation: clinical aplication of vestibular rehabilitation Resumo / SummaryA perda bilateral da função vestibular é rara em pacientes com vertigem e desequilíbrio, porém os sintomas muitas vezes são incapacitantes e seu tratamento é tema controverso na literatura. Objetivo: Nosso objetivo foi avaliar e descrever a resposta clínica de pacientes com distúrbio do equilíbrio corporal secundário à arreflexia vestibular pós-calórica bilateral, documentada pela eletronistagmografia, submetidos à Reabilitação Vestibular. Forma de estudo: Retrospectivo, inclui um desenho de descrição de casos. Método: Foram avaliadas as respostas de 8 pacientes portadores de arreflexia pós-calórica bilateral submetidos à Reabilitação Vestibular, observando-se a relação entre os resultados de exame e sintomas pré e pós-tratamento. A avaliação da resposta clínica foi feita por meio de escala analógico-visual. Resultados: Após a Reabilitação Vestibular, 7 (87,5%) dos 8 pacientes submetidos à terapia apresentaram melhora clínica. Conclusão: embora não seja esperada melhora completa do equilíbrio corporal, a Reabilitação Vestibular é uma terapia eficaz na recuperação desses pacientes.

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Prevalence and Impact of Bilateral Vestibular Hypofunction

Ward

Agrawal

Hoffman

et al. 2013

JAMA Otolaryngol Head Neck Surg

179

100

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Objective Profound bilateral vestibular hypofunction (BVH) causes disabling oscillopsia, chronic disequilibrium and postural instability. Our aim was to assess prevalence and functional impact of BVH in the U.S. adult population. Study Design National cross-sectional survey and corollary validation study. Setting National database Patients Adult participants in the 2008 Balance and Dizziness Supplement to the United States National Health Interview Survey (NHIS), (n=21,782). Intervention Survey-based diagnosis of BVH, all of the following: presence of visual blurring with head movement, unsteadiness, difficulty walking in darkness/unsteady surfaces and in a straight path, symptoms being at least “a big problem” and present for at least 1 year, in the absence of other neurologic conditions or eye pathology affecting vision. Main Outcome Measures Prevalence of BVH, socioeconomic and quality-of-life impact of BVH, and fall risk. Results Adjusted national estimates from this survey indicate the prevalence of BVH in 2008 was 28/100,000 U.S. adults (64,046 Americans). 44% of participants with BVH reported changing their driving habits because of their symptoms, 56% reported reduced participation in social activities, and 58% reported difficulties with activities of daily living. Respondents with BVH had a 31-fold increase in the odds of falling in multivariate analyses compared to all respondents, with 25% reporting a recent fall-related injury. Conclusions BVH, as estimated by the presence of specific symptoms in a nationally representative survey, has considerable socioeconomic and quality-of-life impacts and significantly increases fall risk. These data support the need for new therapeutic strategies for BVH, including vestibular rehabilitation and implantable vestibular prostheses.

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Bilateral Idiopathic Loss of Peripheral Vestibular Function with Normal Hearing

Cited by 72 publications

References 7 publications

Follow-up of vestibular function in bilateral vestibulopathy

Follow-up of vestibular function in bilateral vestibulopathy

Arreflexia pós-calórica bilateral: aplicabilidade clínica da reabilitação vestibular

Prevalence and Impact of Bilateral Vestibular Hypofunction

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