Causative factors and epidemiology of bilateral vestibulopathy in 255 patients.
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.


CONCLUSIONS
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.
Zingler
Vera C
VC
Department of Neurology, Ludwig-Maximilians University, Klinikum Grosshadern, Munich, Germany. vzingler@med.uni-muenchen.de
Cnyrim
Christian
C
Jahn
Klaus
K
Weintz
Eva
E
Fernbacher
Julia
J
Frenzel
Claudia
C
Brandt
Thomas
T
Strupp
Michael
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides / Q000009:adverse effects; D001323:Autoantibodies / Q000097:blood; D015984:Causality; D002526:Cerebellar Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005858:Germany / Q000453:epidemiology; D006311:Hearing Disorders / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000453:epidemiology*; D008581:Meningitis / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013577:Syndrome; D015837:Vestibular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology*
D000617:Aminoglycosides; D001323:Autoantibodies