Bilateral vestibulopathy: the causes, diagnosis, and treatments

Abstract

Purpose of reviewThe current review covers recent advances in bilateral vestibulopathy (BVP) in terms of its etiology, diagnosis, and treatments. Recent findingsThe etiology of BVP depends on its clinical course and associated findings, and genetic abnormalities are increasingly recognized in isolated as well as complicated form of BVP. Recent developments in evaluation of the vestibular function have greatly enhanced the detection of BVP, and introduction of the consensus diagnostic criteria by Barany Society has facilitated research on BVP. Vestibular prosthesis may improve vestibular function, posture, gait and quality of life in patients with BVP and would expand the therapeutic options for BVP in near future. SummaryGenetics is expanding its role in identifying the causes of BVP of hitherto unknown etiology. The detection and investigation of BVP have been greatly enhanced by introduction of consensus diagnostic criteria and recent developments in methodology evaluating the vestibular function. Vestibular prothesis appears promising in managing BVP.

Die sechs häufigsten peripherenvestibulären Syndrome

“…Die Diagnose beruht nach den Diagnosekriterien auf der Anamnese sowie der klinischen und apparativen Diagnostik mit dem sicheren Nachweis eines beidseitigen VOR-Defizits mittels Video-HIT und/oder kalorischer Testung 58 unter Beachtung der Differenzialdiagnosen.…”

“…Hierfür sprechen autoptische Studien, die entzündliche Degenerationen des Vestibularisnervs zeigten, der Nachweis des Herpes-simplex-Virus-Typ-1, des "latency-associated transcripts" in vestibulären Ganglien und aktivierter CD8 + -T-Zellen. Diese Hypothese wird gestützt durch 2 genomweite Assoziationsstudien, die einen Zusammenhang mit Single-Nucleotid-Varianten des "host-factor" für die HSV-1-Replikation und anderen gezeigt haben [48,49] Die Diagnose beruht nach den Diagnosekriterien auf der Anamnese sowie der klinischen und apparativen Diagnostik mit dem sicheren Nachweis eines beidseitigen VOR-Defizits mittels Video-HIT und/oder kalorischer Testung [58] unter Beachtung der Differenzialdiagnosen.…”

Vibrations on mastoid process alter the gait characteristics during walking on different inclines

“…A 2008 National Health Interview Survey estimated that a prevalence of 28 per 100,000 or 64,046 US adults had suffered the BVD. Unexpectedly, because the prevalence of this BVD is relatively low, attention is not obtained ( Kim & Kim, 2022 ) as same as other vestibular disorders, such as benign paroxysmal positional vertigo, vestibular neuronitis, and Meniere’s disease. Several common clinical diagnoses have been developed to identify the patients with BVD, such as the head impulse test ( Halmagyi & Curthoys, 1988 ), dynamic visual acuity ( Demer, Honrubia & Baloh, 1994 ) and caloric testing, which Dr. Robert Barany invented.…”

Efficacy of nGVS to improve postural stability in people with bilateral vestibulopathy: A systematic review and meta-analysis

“…There are multiple potential causes for BVP. Damage to the sensory organs of the vestibular system, the semicircular canals, utricle or saccule may occur in Meniere's disease, mechanical trauma, labyrinthitis or aminoglycoside toxicity (Kim and Kim, 2022 ) or the vestibular nerve may be impaired through neuritis, vestibular schwannoma or resection of the vestibular nerve (Kim and Kim, 2022 ). Around half of BVP cases are idiopathic, making the pathological process difficult to ascertain (Hain et al, 2018 ; Kim and Kim, 2022 ).…”

“…Vestibular hair cells and neurons do not regenerate, and there is currently no established remedial medical treatment for BVP once damage has occurred (Guinand et al, 2012 ; Kim and Kim, 2022 ). To date, the gold standard treatment has been vestibular rehabilitation, which relies on central compensation and reweighting of other sensory inputs (Hall et al, 2016 ; Hain et al, 2018 ).…”