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Causative Factors, Epidemiology, and Follow‐up of Bilateral Vestibulopathy
Author(s) -
Zingler Vera Carina,
Weintz Eva,
Jahn Klaus,
Huppert Doreen,
Cnyrim Christian,
Brandt Thomas,
Strupp Michael
Publication year - 2009
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2009.03765.x
Subject(s) - medicine , electronystagmography , vertigo , vestibular system , peripheral , nystagmus , surgery , pediatrics , audiology
Bilateral vestibulopathy (BV) is characterized by impaired or lost function of both peripheral labyrinths or of the eighth nerves. In a review of 255 patients (mean age ± SD, 62 ± 16 years) with BV diagnosed in the authors’ dizziness unit between 1988 and 2005, 62% of the patients were male. Previous vertigo attacks had occurred in 36%, indicating a sequential manifestation. The definite cause of BV was determined in 24% and the probable cause in 25%. The most common causes were ototoxic aminoglycosides (13%), Ménière's disease (7%), and meningitis (5%). Strikingly, 25% exhibited cerebellar signs. Cerebellar dysfunction was associated with peripheral polyneuropathy in 32% compared with 18% in BV patients without cerebellar signs. In a follow‐up study on 82 BV‐patients (mean age at the time of diagnosis 56.3 ± 17.6 years), the frequency and degree of recovery or worsening of vestibular function over time were determined. The patients were reexamined 51 ± 6 months after the first examination. Electronystagmography with bithermal caloric irrigation was analyzed by measurement of the mean peak slow‐phase velocity (SPV) of the induced nystagmus. Statistical analysis of the mean peak SPV revealed a nonsignificant worsening over time (initial mean peak SPV 3.0 ± 3.5°/s vs. 2.1 ± 2.8°/s). Only patients with BV due to meningitis exhibited an increasing, but nonsignificant SPV (1.0 ± 1.4°/s vs. 1.9 ± 1.6°/s). Forty‐three percent of patients subjectively rated the course of their disease as stable, 28% as worsened, and 29% as improved.