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The Vestibular System01:29

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The vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Related Experiment Video

Updated: May 5, 2026

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Vestibular Involvement in Systemic Autoimmune and Rheumatologic Diseases: A Systematic Review and GRADE-Based

Juan C Amor-Dorado1, Miguel A González-Gay2,3

  • 1Otorhinolaryngology Division, Hospital Can Misses, 07800 Ibiza, Spain.

Journal of Clinical Medicine
|May 4, 2026
PubMed
Summary

Vestibular dysfunction is common in autoimmune diseases, but evidence is limited. More standardized research is needed to understand specific vestibular issues in conditions like systemic sclerosis and giant cell arteritis.

Keywords:
GRADEautoimmune diseasesbalance disordersbenign paroxysmal positional vertigogiant cell arteritisrheumatologic diseasessystematic reviewsystemic sclerosisvestibular assessmentvestibular dysfunction

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Area of Science:

  • Rheumatology
  • Neurology
  • Otolaryngology

Background:

  • Vestibular symptoms and dysfunction are noted in autoimmune and rheumatologic diseases.
  • Existing evidence is fragmented and methodologically varied.
  • Audiovestibular involvement is often studied together, hindering disease-specific interpretation.

Purpose of the Study:

  • To systematically review vestibular outcomes in autoimmune and systemic rheumatologic diseases.
  • To synthesize available evidence on vestibular dysfunction in these patient populations.

Main Methods:

  • A PRISMA 2020-based systematic review was performed.
  • Included observational studies reporting vestibular symptoms or objective test results.
  • Certainty of evidence was assessed using the GRADE approach.

Main Results:

  • Twenty-seven studies (14 primary, 13 reviews) were included.
  • Vestibular involvement was reported in systemic sclerosis, giant cell arteritis, and others.
  • Caloric testing, balance measures, videonystagmography, and vHIT identified abnormalities.

Conclusions:

  • Vestibular involvement is present across various autoimmune and inflammatory diseases.
  • The overall certainty of evidence is limited.
  • Standardized assessments and longitudinal studies are crucial for defining disease-specific vestibular phenotypes.