Bilateral Vestibular Hypofunction in Quantitative Head Impulse Test: Clinical Characteristics in 23 Patients

Abstract

OBJECTIVE: To explore clinical features of patients with bilateral vestibular hypofunction (BVH) verified in motorized head impulse test (MHIT). MATERIALS and METHODS:We examined clinical records of 23 adult patients (10 males and 13 females), whose gain of the vestibulo-ocular reflex in the MHIT was bilaterally lowered. Fifteen of 62 unilateral cochlear implant (CI) recipients routinely tested both pre-and postoperatively with the MHIT had BVH. Eight of 198 vestibular outpatients selected to the MHIT due to clinical causes had BVH. Clinical characteristics and a questionnaire regarding current sensations were analyzed. RESULTS:The mean gain±SD in the MHIT was 0.26±0.17 on the right and 0.26±0.14 on the left side. The mean gain in the CI recipients did not differ from that of vestibular outpatients (p>0.05). All outpatients with BVH suffered from oscillopsia, whereas only 46% of CI recipients experienced oscillopsia (p=0.048). Instability was more prominent (p=0.004) and quality of life further decreased (p=0.012) among vestibular outpatients compared with CI patients. Most common etiology for the BVH was meningitis. Other causes were either sudden or progressive loss of labyrinthine function, bilateral Meniére's disease, and ototoxicity. CONCLUSION:BVH is rare even in a specialized clinic. Vestibular outpatients were more disabled than CI recipients with the BVH.

Functional Loss After Meningitis—Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

“…From the studies referenced above, it appears that some association does exist between hearing loss and vestibular loss after meningitis, which makes sense as the inflammation/infection may spread to all compartments of the inner ear ( 23 , 24 ). However, Levo et al ( 7 ) investigated 23 patients with bilateral vestibular hypofunction as measured with a motorized head impulse test. In seven cases, the etiology was meningitis.…”

Cochlear Implantation in Meniere's Disease: A Systematic Review and Meta‐Analysis

“…Of 37 studies included, 32 (86.5%) studies were full manuscripts [8][9][10][11][12][13] and five (13.5%) were conference abstracts. [43][44][45][46][47] 21 (56.8%) papers were case series (more than one patient), [19][20][21][22][25][26][27][28][29][30]36,37,40,[43][44][45][46][47] 11 (29.7%) were case reports (one patient), 23,24,[30][31][32][33][34][35]38,39,41,42 and five (13.5%) were case-control studies (one or more comparison groups). [8][9][10][11][12] Twenty-five (67.6%) studies were based internationally and 12 (32.4%) studies were based in the United States (Table I).…”