Otolith dysfunction in bilateral vestibulopathys

Introduction:

The diagnosis of bilateral vestibulopathy (BVP) depends mainly on patient history such as movement-dependent unsteadiness, which worsens in darkness and/or on uneven ground. In almost all cases a bilateral significantly impaired or absent function of the vestibulo-ocular reflex (VOR) is present. In some cases there is otolith dysfunction.

The aim of this study is to test the validity of the otolith function test in bilateral vestibulopathy.

Materials and methods:

The results of labyrinth function tests were evaluated in 15 patients (age 46 – 86) (m/f ratio: 14/1), who were admitted to our department from 10/2017 to 10/2018 and who were diagnosed with bilateral vestibulopathy.

All patients underwent caloric testing, video head impulse test (v-HIT), cervical and ocular Vestibular Evoked Myogenic Potentials (VEMP), subjective vertical testing (SVV), sensory organization test (SOT) as well as oculomotor testings.

It was elicited how often otolith dysfunction in BVp occurred.

Results:

Caloric testing revealed bilateral hyporreflexia or arreflexia in all patients.. Furthermore, video head impulse test (v- HIT) yielded pathological results in all cases.

Failed response to ocular VEMPs was detected bilaterally in 10 patients and unilaterally in 1 patient. Furthermore, failed response to cervical VEMPs was documented bilaterally in 8 patients and unilaterally in 5 patients. Pathological deviation of SVV was diagnosed in 14 of 15 cases.

Conclusion:

Otolith function diagnostics play an important role in labyrinth testing.

Our study has shown that in most cases of bilateral vestibulopathy there is also a pathological otolith function.

Publication History

Publication Date:
23 April 2019 (online)