Bilateral peripheral vestibulopathy

Zhiznevskiy D.V.; Zamergrad M.V.; Levin O.S.; Azimova A.A.

doi:https://doi.org/10.17116/jnevro202312304124

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Abstract:

Bilateral vestibulopathy is a relatively widespread and at the same time rarely diagnosed cause of chronic postural instability. Numerous toxic factors, dysmetabolic, autoimmune and neurodegenerative processes can lead to this condition. The main clinical manifestations of bilateral vestibulopathy are balance disorders and visual disturbances (oscillopsia), which can significantly increase the risks of falls in such patients. In addition, cognitive and affective disorders, which also reduce the quality of life in patients with bilateral vestibulopathy, have been described and actively studied in recent years. The diagnosis of bilateral vestibulopathy is based on the results of a clinical neurovestibular study, including a dynamic visual acuity test and a Halmagyi test. A video head impulse test, a bithermal caloric test and a sinusoidal rotation test are used as instrumental methods confirming the dysfunction of the peripheral vestibular system. However, they are still not widespread in neurological practice. Treatment of bilateral vestibulopathy is reduced to vestibular rehabilitation. Encouraging results have been obtained in a number of studies using galvanic vestibular stimulation and the use of vestibular implants. In addition, cognitive rehabilitation methods are currently being developed, which presumably can also improve compensation for bilateral vestibular loss.

Keywords:

bilateral vestibulopathy

presbivestibulopathy

oscillopsia

balance disorders

vestibuloocular reflex

vestibulospinal reflex

vestibular rehabilitation

Authors:

Zhiznevskiy D.V.

Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0002-8945-381X

Zamergrad M.V.

Russian Medical Academy of Continuous Professional Education;
Russian Gerontology Clinical Research Center of Pirogov Russian National Research Medical University

SPIN RSCI: 4521-6350
Scopus AuthorID: 35773896900
ORCID: 0000-0002-0193-2243

Levin O.S.

Russian Medical Academy of Continuous Professional Education

SPIN RSCI: 5342-1373
Scopus AuthorID: 57147160800
ORCID: 0000-0003-3872-5923

Azimova A.A.

Russian Medical Academy of Continuous Professional Education

ORCID: 0000-0001-9414-1936

Received:

30.11.2022

Accepted:

14.12.2022

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References:

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