Clinical Analysis of 42 Patients with Bilateral Vestibulopathy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To find out the causative factors and clinical features of bilateral vestibulopathy in the Korean population. SUBJECTS AND METHOD: The data of 42 patients (mean age: 55.04+/-18.87 years) with bilateral vestibulopathy were reviewed retrospectively between 1997 and 2009. We carried out a full neurotological examination, electronystagmography, a bithermal caloric test, a rotatory chair test, cranial imaging and laboratory studies. RESULTS: Nineteen patients (45.24%) were diagnosed as having secondary bilateral vestibulopathy with causative factors. The most common cause was ototoxic drug (14.29%). Other etiologic causes were labyrinthitis, temporal bone fracture, Meniere's disease, peripheral neuropathy and meningitis/encephalitis. Forty-five percent of all patients had symptoms that lasted less than 1 month, and about 43% of the patients presented with chronic progressive symptoms of over 1 year. CONCLUSION: In about 54% of all patients, we couldn't find any causative factors leading to bilateral vestibulopathy. Because a large subgroup of patients had a history of dizziness over one year, an adequate number of studies on vestibular and cerebellar function are recommended for patients of chronic dizziness to exclude bilateral vestibulopathy.

A Case of Neurovascular Cross-compression of the Eighth Cranial Nerve Representing Longstanding Uncompensated Vestibular Hypofunction / 대한평형의학회지

The neurovascular cross-compression (NVCC) of the eighth cranial nerve (CN) is a clinical entity with symptoms of recurrent vertigo or tinnitus. Although the diagnostic criteria have been defined, the precise clinical presentation and pathomechanism have not been clarified. The treatment response to the carbamazepine; drug of choice for first line medical treatment, has been considered as one of the diagnostic criteria. Herein, we present a case of chronic uncompensated unilateral vestibular hypofunction who responded dramatically to carbamazepine medication. A 55 year-old male admitted to the hospital with symptoms of recurrent oscillopsia and headache for more than 7 years. His symptoms were aggravated by positional changes. Vestibular function tests showed spontaneous nystagmus, canal paresis on caloric test and vestibular dysfunction on dynamic posturography, which represented unilateral uncompensated vestibular hypofunction. Although his symptom was not relived by vestibular rehabilitation, he was treated with carbamazepine. A long standing uncompensated unilateral vestibular hypofunction without any auditory symptoms could be one of the clinical presentations in NVCC of the eighth CN.