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[Bilateral vestibulopathy].

R Huang1, G R Bi1

  • 1Department of Neurology, Shengjing Hospital of China Medical University.

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Journal of Clinical Otorhinolaryngology Head and Neck Surgery
|May 26, 2018
PubMed
Summary
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Bilateral vestibulopathy (BVP) causes balance and gait issues. Diagnosis involves assessing the vestibulo-ocular reflex (VOR), with treatments including exercises and addressing underlying causes.

Area of Science:

  • Neurology
  • Otolaryngology
  • Neuroscience

Background:

  • Bilateral vestibulopathy (BVP) presents with postural imbalance, gait unsteadiness, and impaired spatial memory/navigation.
  • Etiology is unknown in over 50% of cases, often suggesting neurodegeneration.
  • Known causes include ototoxicity (gentamicin), Menière's disease, autoimmune disorders, meningitis, and vestibular schwannoma.

Purpose of the Study:

  • To summarize the clinical presentation, diagnosis, and management of bilateral vestibulopathy (BVP).
  • To highlight the diagnostic criteria based on vestibulo-ocular reflex (VOR) function.
  • To outline current treatment strategies for BVP.

Main Methods:

  • Diagnosis relies on assessing bilaterally reduced or absent vestibulo-ocular reflex (VOR) function.
Keywords:
bilateral vestibulopathydynamic visual acuityhead impulse testvestibular-evoked myogenic potentialsvestibulo-ocular reflexvideo-oculography system

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  • Diagnostic tools include the head impulse test (HIT), video-oculography (vHIT), and vestibular-evoked myogenic potentials (VEMPs).
  • Subtyping of BVP is based on affected anatomical structures and VOR frequency ranges.

    • Main Results:

    • BVP symptoms significantly impact balance, gait, and spatial orientation.
    • Diagnostic tests confirm reduced or absent VOR function.
    • Four subtypes of BVP are identified based on VOR deficits.

    Conclusions:

    • Effective management of BVP involves patient education, vestibular rehabilitation exercises, and treating underlying conditions.
    • Preventive measures, such as limiting ototoxic substance use, are crucial.
    • Further research into the neurodegenerative causes of BVP is warranted.