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Idiopathic bilateral vestibular loss

E W Sargent1, J A Goebel, J M Hanson

  • 1Department of Otolaryngology-Head and Neck Surgery, St. Louis University School of Medicine, MO 63110-0250, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 1, 1997
PubMed
Summary

Idiopathic bilateral vestibular loss, affecting balance and vision, can be diagnosed in an office setting. This condition may stem from vestibular neuritis or age-related decline.

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Area of Science:

  • Neurology
  • Otolaryngology
  • Vestibular System

Background:

  • Idiopathic bilateral vestibular loss (BVL) is a condition characterized by a loss of peripheral vestibular sensitivity without a known cause.
  • This study details the clinical and laboratory findings in 13 patients diagnosed with BVL.

Observation:

  • Office-based screening for BVL can be achieved through specific eye-movement tests and examination for refixation saccades during head movements.
  • Diagnosis is confirmed via reduced caloric responses and diminished vestibulo-ocular reflex (VOR) gain during rotational chair testing.
  • Patients, with a mean age of 68 years, presented with either vertigo or insidious disequilibrium, and many performed poorly on balance tests, especially without visual or somatosensory input.

Findings:

  • Two distinct symptom onset patterns were observed: vertigo (10 patients) and progressive disequilibrium without vertigo (3 patients).

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  • Subjective oscillopsia was reported by only 38% of patients.
  • Poor performance on platform posturography was noted, particularly under conditions of sensory deprivation.

    • Implications:

    • BVL associated with vertigo may indicate bilateral sequential vestibular neuritis.
    • BVL presenting as disequilibrium could be due to age-related symmetrical peripheral function loss.
    • While this study focused on elderly individuals, idiopathic BVL affects patients across all age groups, highlighting the need for broader diagnostic awareness.