On the age dependence of unilateral and bilateral vestibulopathies at otolith organ level

Introduction:

With the introduction of dedicated examination procedures in clinical labyrinth testing for the targeted examination of otolith functions (cVEMP, oVEMP, Subjective Visual Vertical), otolith dysfunction as a possible cause of acute or chronic dizziness is increasingly becoming a diagnostic focus. Their function, which can be elicited specifically for each side, determines the presence of unilateral or bilateral vestibulopathy. Literature data also suggest that in the affected patients, semicircular canal dysfunction is less perceived in the elderly than otolith dysfunction.

Patients and Methods:

In the current study we evaluated data from 28 patients aged 45 – 86, who received a in-patient labyrinth testing in our department during the period from 23 rd June 2016 until 30th October 2018. The findings of otolith and semicircular function were compared with respect to patients' age.

Results:

In the group of patients examined, we found similar functional deviations in the results of oVEMP, cVEMP or SVV as in the studies on semicircular canal disorders (VKIT or caloric testing). Particularly in older patients, the assignment of subjective complaints to a decidedly otolith-dependent complaint was more difficult, as further deficits often contribute to inconsistent symptoms ("complex dizziness").

Discussion:

The results are in accordance with previously published data from the literature. According to our experience in older patients the otolithic function loss becomes less clinically present in the light of concomitant functional limitations of visual or proprioceptive control.

Publication History

Publication Date:
23 April 2019 (online)