Bilateral loss of caloric response in conscious patients (areflexia vestibularis)

Twenty-six of 11 793 consecutive vestibular examinations showed no vestibular response to bilateral irrigation with 20 degrees C water (areflexia vestibularis). CNS malignancies, infections, congenital disorders, drugs and various central nervous system disorders were found to be the most frequent aetiological factors. Associated sensorineural hearing loss--infection expected--was an uncommon finding as 17 of 26 examinations showed no auditory impairment.