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. 2020 Dec;267(Suppl 1):241-255.
doi: 10.1007/s00415-020-10243-5. Epub 2020 Oct 8.

Bilateral vestibulopathy: beyond imbalance and oscillopsia

F M P Lucieer  1 , R Van Hecke  2 , L van Stiphout  3 , S Duijn  4 , A Perez-Fornos  5 , N Guinand  5 , V Van Rompaey  6 , H Kingma  3   7 , M Joore  8 , R van de Berg  3   7
Affiliations

Bilateral vestibulopathy: beyond imbalance and oscillopsia

F M P Lucieer et al. J Neurol. 2020 Dec.

Abstract

Objective: To optimize the current diagnostic and treatment procedures for patients with bilateral vestibulopathy (BV), this study aimed to determine the complete spectrum of symptoms associated with BV.

Method: A prospective mixed-method study design was used. Qualitative data were collected by performing semi-structured interviews about symptoms, context, and behavior. The interviews were recorded and transcribed until no new information was obtained. Transcriptions were analyzed in consensus by two independent researchers. In comparison to the qualitative results, quantitative data were collected using the Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS) and a health-related quality of life questionnaire (EQ-5D-5L).

Results: Eighteen interviews were transcribed. Reported symptoms were divided into fourteen physical symptoms, four cognitive symptoms, and six emotions. Symptoms increased in many situations, such as darkness (100%), uneven ground (61%), cycling (94%) or driving a car (56%). These symptoms associated with BV often resulted in behavioral changes: activities were performed more slowly, with greater attention, or were avoided. The DHI showed a mean score of severe handicap (54.67). The HADS questionnaire showed on average normal results (anxiety = 7.67, depression = 6.22). The EQ-5D-5L demonstrated a mean index value of 0.680, which is lower compared to the Dutch age-adjusted reference 0.839 (60-70 years).

Conclusion: BV frequently leads to physical, cognitive, and emotional complaints, which often results in a diminished quality of life. Importantly, this wide range of symptoms is currently underrated in literature and should be taken into consideration during the development of candidacy criteria and/or outcome measures for therapeutic interventions such as the vestibular implant.

Keywords: Bilateral vestibular hypofunction; Bilateral vestibulopathy; Outcome measures; Symptoms; Vestibular implant; Vestibular prosthesis.

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Conflict of interest statement

see “Funding”.

Figures

Fig. 1
Fig. 1
Mind map of physical symptoms, as reported by BV patients (n = 18) during semi-structured interviews. The larger the font size of a specific symptom, the more often this symptom was addressed during the interviews
Fig. 2
Fig. 2
Mind map of cognitive symptoms, as reported by BV patients (n = 18) during semi-structured interviews. The larger the font size of a specific symptom, the more often this symptom was addressed during the interviews
Fig. 3
Fig. 3
Mind map of emotions, as reported by BV patients (n = 18) during semi-structured interviews. The larger the font size of a specific emotion, the more often this emotion was addressed during the interviews
Fig. 4
Fig. 4
Conceptual model of altered behavior when performing specific activities and their interaction, as reported by BV patients (n = 18) during semi-structured interviews. Arrows indicate an interaction between items
See this image and copyright information in PMC

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