January 20, 2023

What is bilateral vestibulopathy?

Bilateral vestibulopathy (BVP) is damage to the vestibular system in the inner ear, which is part of the balance system. In BVP both sides are affected. Basically, it is a reduced or absent vestibular function on both sides, resulting from deficits in the labyrinths, vestibular nerves, or their combination.  
BVP is also known as bilateral vestibular weakness, bilateral vestibular hypofunction, bilateral vestibular failure, or bilateral vestibular loss.

The prevalence of BVP in the US adult population was estimated to be 28 per 100,000 in 2008.  
The age distribution of patients with BVP ranges from youth to old age depending on the etiology. The mean age at which the diagnosis of acquired BVP is established is given as around 50–60 years.

Many different things can damage the inner ear, including:
– Vestibular toxicity: damage to the inner ear by drugs such as gentamicin or similar antibiotics.
– Meniere’s disease in both ears.
– Acoustic neuroma in both ears, or surgery to treat acoustic neuroma.
– Meningitis.
– Autoimmune disorders, including autoimmune inner ear disease (AIED).
– Neurodegenerative disorders which cause gradual loss of function or death of nerve cells in the brain.
– Idiopathic, or it is not clear what caused the damage.

  – Loss of balance (also called postural imbalance or loss of postural control).
  – Unsteady gait (when walking or running).
  – Feeling unstable or dizzy.
  – Oscillopsia: blurry or jumpy vision when the head moves (when walking or running).
– The balance and gait problems get worse when it is dark, or when the person is on an uneven or a moving surface.
– Patients with BVP usually do not have feelings of spinning (vertigo).

– Avoiding situations that could be unsafe or could make your symptoms worse, such as driving or walking on uneven ground at night.
– Vestibular rehabilitation is a type of exercise-based therapy. Its goal is to help your brain relearn how to balance and how to respond to signals from the visual, vestibular, and proprioceptive systems, or how to compensate if some signals are missing.
  – If the symptoms are very severe, people with BVP may need to use devices like walkers, crutches, canes or wheelchairs, especially for the first 3 to 6 months.


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