Causative factors and epidemiology of bilateral vestibulopathy in 255 patients.

Abstract

OBJECTIVE:

To determine the causative factors and epidemiology of bilateral vestibulopathy (BV).

METHODS:

This is a retrospective review of 255 patients (mean age, 62 +/- 16 years) with BV diagnosed in our dizziness unit between 1988 and 2005. All patients had undergone a standardized neurophthalmological and neurootological examination, electronystagmography with caloric irrigation, cranial magnetic resonance imaging or computed tomography (n = 214), and laboratory tests.

RESULTS:

Sixty-two percent of the study population were male subjects. Previous vertigo attacks had occurred in 36%, indicating a sequential manifestation. The definite cause of BV was determined in 24% and the probable cause in 25%: The most common causes were ototoxic aminoglycosides (13%), Menière's disease (7%), and meningitis (5%). Strikingly, 25% exhibited cerebellar signs. Cerebellar dysfunction was associated with peripheral polyneuropathy in 32% compared with 18% in BV patients without cerebellar signs. Hypoacusis occurred bilaterally in 25% and unilaterally in 6% of all patients. It appeared most often in patients with BV caused by Cogan's syndrome, meningitis, or Menière's disease.

INTERPRETATION:

The cause of BV remains unclear in about half of all patients despite intensive examinations. A large subgroup of these patients have associated cerebellar dysfunction and peripheral polyneuropathy. This suggests a new syndrome that may be caused by neurodegenerative or autoimmune processes.

• Authors: Vera C Zingler, Christian Cnyrim, Klaus Jahn, Eva Weintz, Julia Fernbacher, Claudia Frenzel, Thomas Brandt, Michael Strupp
• Journal: Annals of neurology (Ann Neurol) Vol. 61 Issue 6 Pg. 524-32 (Jun 2007) ISSN: 0364-5134 [Print] United States
• PMID: 17393465 (Publication Type: Journal Article)

Chemical References

• Aminoglycosides
• Autoantibodies

Topics

• Adolescent
• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Aminoglycosides (adverse effects)
• Autoantibodies (blood)
• Causality
• Cerebellar Diseases (epidemiology, physiopathology)
• Child
• Comorbidity
• Disease Progression
• Female
• Germany (epidemiology)
• Hearing Disorders (blood, epidemiology, immunology)
• Humans
• Male
• Meniere Disease (epidemiology)
• Meningitis (epidemiology)
• Middle Aged
• Retrospective Studies
• Sex Distribution
• Syndrome
• Vestibular Diseases (epidemiology, etiology, physiopathology)