Diabetic polyneuropathy may increase the handicap related to vestibular disease

We undertook this study to assess the influence of diabetic peripheral neuropathy on self-reported disability and postural control during quiet stance of patients with peripheral vestibular disease, before and after a standardized program of vestibular rehabilitation (Cawthorne & Cooksey exercises).

Twenty patients with peripheral vestibular disease participated in the study (mean age 56+/-7.8 years), 10 with and 10 without peripheral neuropathy (age matched). The Dizziness Handicap Inventory and static posturography (eyes open/closed and firm/soft surface) were evaluated prior to rehabilitation and at week 7 of follow-up.

Compared to patients without neuropathy, patients with neuropathy had more time elapsed since the diabetes was diagnosed, higher glycemia and HbAc level and higher composite scores on the Dizziness Handicap Inventory, but similar results on static posturography. After rehabilitation, although scores on the Dizziness Handicap Inventory decreased in the two groups, the difference between them persisted. In patients with neuropathy, static posturography showed improvement of postural control only with the eyes closed and soft surface, whereas in patients without neuropathy the postural control improved during all sensory conditions (eyes open/closed and firm/soft surface).

In diabetic patients with peripheral vestibular disease, peripheral neuropathy contributes to self-reported disability and may interfere with complete balance recovery.