Bilateral vestibular paresis: diagnosis and treatment. 1991

S A Telian, and N T Shepard, and M Smith-Wheelock, and M Hoberg
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109.

Patients with bilateral peripheral vestibular dysfunction present a substantial diagnostic and therapeutic challenge to the otologist. Caloric irrigations that suggest bilateral weakness may mislead the clinician when considerable peripheral function remains. Rotary chair testing at several frequencies is helpful in confirming the degree of residual function and may identify patients who have a better prognosis in rehabilitation. Forty-nine patients with bilateral vestibular paresis were evaluated. The diagnosis was based on caloric responses of less than 5 degrees/sec in both ears and reduced gain on rotary chair trials. Oscillopsia occurred in the minority of patients (35%) and was rare unless severe paresis was present. Episodic vertigo occurred in 43%. All patients had abnormal posturography results, with vestibular dysfunction and severe dysfunction patterns predominating. The treatment outcomes of 22 patients who underwent vestibular rehabilitation are discussed. Prevention of bilateral vestibular paresis remains a high priority.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010037 Otolithic Membrane A gelatinous membrane overlying the acoustic maculae of SACCULE AND UTRICLE. It contains minute crystalline particles (otoliths) of CALCIUM CARBONATE and protein on its outer surface. In response to head movement, the otoliths shift causing distortion of the vestibular hair cells which transduce nerve signals to the BRAIN for interpretation of equilibrium. Otoconia,Otoliths,Statoconia,Membrane, Otolithic,Membranes, Otolithic,Otoconias,Otolith,Otolithic Membranes,Statoconias
D010243 Paralysis A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45) Palsy,Plegia,Todd Paralysis,Todd's Paralysis,Palsies,Paralyses,Paralysis, Todd,Paralysis, Todd's,Plegias,Todds Paralysis
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D002150 Caloric Tests Elicitation of a rotatory nystagmus by stimulating the semicircular canals with water or air which is above or below body temperature. In warm caloric stimulation a rotatory nystagmus is developed toward the side of the stimulated ear; in cold, away from the stimulated side. Absence of nystagmus indicates the labyrinth is not functioning. Barany Test,Barany's Test,Baranys Test,Caloric Test,Test, Barany,Test, Barany's,Test, Caloric,Tests, Caloric
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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