- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index
(p. 281) Bilateral Vestibular Failure: Causes and Courses
- Chapter:
- (p. 281) Bilateral Vestibular Failure: Causes and Courses
- Author(s):
Thomas Brandt
, Marianne Dieterich
, and Michael Strupp
- DOI:
- 10.1093/med/9780199608997.003.0026
Bilateral vestibular failure (BVF) due to bilateral disorders of the labyrinth or the eighth nerves accounts for about 6% of outpatients in a neurological dizziness unit. BVF has various etiologies: the most frequent are ototoxic antibiotics, Menière’s disease, meningitis, and neurodegenerative disorders. Its etiology remains unclear in approximately half of the patients. The diagnosis is often not established despite the presence of the typical key symptoms of oscillopsia and blurred vision during head movements (defective vestibulo-ocular reflex) and unsteadiness of stance and gait in the dark (defective vestibulo-spinal postural control). The diagnostic proof is based on a pathological head-impulse test and severe hypo- or unresponsiveness to bithermal caloric irrigation. Treatment is limited and follows three lines of action: prophylaxis of progressive vestibular loss, recovery of vestibular function, and most important, physical therapy that promotes compensation and substitution of missing vestibular input by visual and somatosensory cues. Long-term follow-up reveals that the spontaneous course is unfavorable: there is only limited improvement, particularly in patients with idiopathic BVF or with meningitis.
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- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index