Journal of Neurology

, Volume 245, Issue 6, pp 314–321

Bilateral loss of vestibular function: clinical findings in 53 patients

  • T. Rinne
  • A. M. Bronstein
  • P. Rudge
  • M. A. Gresty
  • L. M. Luxon
Original communication

DOI: 10.1007/s004150050225

Cite this article as:
Rinne, T., Bronstein, A., Rudge, P. et al. J Neurol (1998) 245: 314. doi:10.1007/s004150050225

Abstract

The clinical presentations and aetiologies of a series of 53 cases of bilateral vestibular failure (BVF) seen by the authors over a decade were evaluated by retrospective review of the medical records. Thirty-nine per cent of patients had associated neurological disease; 13% had a progressive cerebellar syndrome with disabling gait ataxia, abnormal eye movements and cerebellar atrophy on neuro-imaging. BVF was usually unsuspected. Nine per cent had cranial or peripheral neuropathies and in this group there was no abnormality of brain stem/cerebellar oculomotor function, but hearing loss was common. Eleven per cent revealed BVF and hearing loss secondary to meningitis, and 6% had other neurological disorders. Idiopathic BVF was found in 21% of cases, characterised by paroxysmal vertigo and/or oscillopsia, but no abnormal clinical signs. Gentamicin ototoxicity accounted for a further 17%, while autoimmune disease was present in 9% of patients. Otological or neoplastic disease was diagnosed in the remaining 13% of patients. It was concluded that neurological, audiological and ocular motor assessments allow the probable cause of BVF to be defined in approximately 80% of cases. A group of BVF related to autoimmune pathologies is reported for the first time, indicating the need for immunological screening. Idiopathic BVF may present with only minor visual or vestibular symptoms, while in patients with cerebellar degeneration, BVF may be unsuspected and, thus, underdiagnosed.

Key words Vestibular failureNeurological diseaseOtologicaldisordersOtotoxicityAutoimminedisordersOscillopsia

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • T. Rinne
    • 1
  • A. M. Bronstein
    • 1
  • P. Rudge
    • 1
  • M. A. Gresty
    • 1
  • L. M. Luxon
    • 2
  1. 1.MCR Human Movement and Balance Unit, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK Tel.: +44-171-837-3611 Fax: +44-171-829-8720GB
  2. 2.Department of Neurotology, The National Hospital for Neurology & Neurosurgery, Queen Square, London WC1N 3BG, UKGB