Recent advances in idiopathic bilateral vestibulopathy: a literature review
Open Access
- 19 August 2019
- journal article
- review article
- Published by Springer Science and Business Media LLC in Orphanet Journal of Rare Diseases
- Vol. 14 (1), 1-6
- https://doi.org/10.1186/s13023-019-1180-8
Abstract
Idiopathic bilateral vestibulopathy (IBV) is an acquired bilateral peripheral vestibular dysfunction of unknown etiology, with persistent unsteadiness but without sensorineural hearing loss (SNHL) other than age-related hearing loss (ARHL). The prevalence of IBV is unknown. The most common symptom is persistent unsteadiness, particularly in darkness and/or on uneven ground. The other main symptom is oscillopsia during head and body movements. IBV is neither associated with SNHL, except for ARHL, nor any other neurological dysfunction that causes balance disorders. The clinical time course of IBV can generally be divided into two main types: progressive type and sequential type. The progressive type involves gradually progressive persistent unsteadiness without episodes of vertigo. The sequential type involves recurrent vertigo attacks accompanied by persistent unsteadiness. Originally, IBV was found to exhibit bilateral dysfunction in the lateral semicircular canals (LSCCs) and the superior vestibular nerve (SVN) system. However, recently, with the development of more sophisticated vestibular function tests of the otolith organs and vertical semicircular canals, it has been revealed that IBV involves peripheral vestibular lesions other than those already identified in the LSCC and the SVN system. Furthermore, novel subtypes of IBV that do not involve bilateral dysfunction of the LSCC and/or the SVN system have been proposed. Therapeutically, exercise-based vestibular rehabilitation in adult bilateral vestibulopathy (BVP) patients has resulted in improved gaze and postural stability moderately. There are several technical approaches for the treatment of BVP such as vestibular implants, sensory substitution devices and noisy galvanic vestibular stimulation. Combined use of various vestibular function tests, including recently developed tests, revealed the diversity of lesion sites in IBV. Further studies are required to determine the therapeutic effects of the technical approaches on IBV.Keywords
Funding Information
- Takeda Science Foundation (304-30)
This publication has 68 references indexed in Scilit:
- Vergence and Standing Balance in Subjects with Idiopathic Bilateral Loss of Vestibular FunctionPLOS ONE, 2013
- Effects of electrotactile vestibular substitution on rehabilitation of patients with bilateral vestibular lossNeuroscience Letters, 2010
- The video head impulse testNeurology, 2009
- The role of the superior vestibular nerve in generating ocular vestibular-evoked myogenic potentials to bone conducted vibration at FzClinical Neurophysiology, 2009
- Vestibular Neuropathy and Vestibular Evoked Myogenic PotentialPublished by Springer Science and Business Media LLC ,2009
- Mitochondrial 12S rRNA susceptibility mutations in aminoglycoside-associated and idiopathic bilateral vestibulopathyBiochemical and Biophysical Research Communications, 2008
- Noisy vestibular stimulation improves autonomic and motor responsiveness in central neurodegenerative disordersAnnals of Neurology, 2005
- Lesion site in idiopathic bilateral vestibulopathy: A galvanic vestibular-evoked myogenic potential studyActa Oto-Laryngologica, 2005
- Bilateral Idiopathic Loss of Peripheral Vestibular Function with Normal HearingActa Oto-Laryngologica, 1995
- Bilateral Vestibular NeuronitisActa Oto-Laryngologica, 1993