Isolated bilateral posterior semicircular canal hypofunction: comparison with bilateral vestibulopathy

Area of Science:

• Vestibular system disorders
• Otolaryngology
• Neurology

Background:

• Chronic unsteadiness is a common vestibular clinic complaint.
• Bilateral vestibulopathy (BVP) often causes unsteadiness but is frequently overlooked.
• Isolated vertical canal hypofunction can be undiagnosed despite established BVP criteria.

Purpose of the Study:

• Compare features of isolated bilateral posterior semicircular canal hypofunction (IBPH) with Barany criteria-diagnosed BVP.
• Identify diagnostic differences and clinical presentations between IBPH and BVP.

Main Methods:

• Analyzed clinical data from 8 IBPH patients diagnosed with specific criteria.
• Compared IBPH patients with 6 BVP patients diagnosed using Barany criteria.
• Utilized video head-impulse testing and stabilometry for diagnosis.

Main Results:

• IBPH patients were all over 70 years old; BVP patients had a wider age range.
• BVP patients reported oscillopsia during movement and unsteadiness in darkness.
• IBPH patients reported unsteadiness in darkness without oscillopsia during movement, with milder findings.

Conclusions:

• Isolated bilateral posterior semicircular canal hypofunction can cause mild unsteadiness in the elderly.
• IBPH is a potential cause of unsteadiness in older adults.
• Awareness of IBPH is crucial for clinicians managing elderly patients with unsteadiness.