Causative factors and epidemiology of bilateral vestibulopathy in 255 patients

被引:201
作者
Zingler, Vera C. [1 ]
Cnyrim, Christian [1 ]
Jahn, Klaus [1 ]
Weintz, Eva [1 ]
Fernbacher, Julia [1 ]
Frenzel, Claudia [1 ]
Brandt, Thomas [1 ]
Strupp, Michael [1 ]
机构
[1] Univ Munich, Klinikum Grosshadern, Dept Neurol, D-81377 Munich, Germany
关键词
D O I
10.1002/ana.21105
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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%), Meni re'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 Meniere'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.
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页码:524 / 532
页数:9
相关论文
共 35 条
[1]   Systemic autoantibodies against discrete inner ear compartments in bilateral vestibular loss [J].
Agrup, CA ;
Keir, G ;
Thompson, EJ ;
Bronstein, AM .
NEUROLOGY, 2005, 65 (01) :167-167
[2]   Serum antibodies against membranous labyrinth in patients with "idiopathic" bilateral vestibulopathy [J].
Arbusow, V ;
Strupp, M ;
Dieterich, M ;
Stocker, W ;
Naumann, A ;
Schulz, P ;
Brandt, T .
JOURNAL OF NEUROLOGY, 1998, 245 (03) :132-136
[3]   IDIOPATHIC BILATERAL VESTIBULOPATHY [J].
BALOH, RW ;
JACOBSON, K ;
HONRUBIA, V .
NEUROLOGY, 1989, 39 (02) :272-275
[4]   CHANGES IN THE HUMAN VESTIBULO-OCULAR REFLEX AFTER LOSS OF PERIPHERAL SENSITIVITY [J].
BALOH, RW ;
HONRUBIA, V ;
YEE, RD ;
HESS, K .
ANNALS OF NEUROLOGY, 1984, 16 (02) :222-228
[5]   SEQUELAE FROM BACTERIAL-MENINGITIS AND THEIR RELATION TO THE CLINICAL CONDITION DURING ACUTE ILLNESS, BASED ON 667 QUESTIONNAIRE RETURNS .2. [J].
BOHR, V ;
HANSEN, B ;
KJERSEM, H ;
RASMUSSEN, N ;
JOHNSEN, N ;
KRISTENSEN, HS ;
JESSEN, O .
JOURNAL OF INFECTION, 1983, 7 (02) :102-110
[6]   Immune-mediated inner ear disease [J].
Bovo, R. ;
Aimoni, C. ;
Martini, A. .
ACTA OTO-LARYNGOLOGICA, 2006, 126 (10) :1012-1021
[7]   Vestibular loss causes hippocampal atrophy and impaired spatial memory in humans [J].
Brandt, T ;
Schautzer, F ;
Hamilton, DA ;
Brüning, R ;
Markowitsch, HJ ;
Kalla, R ;
Darlington, C ;
Smith, P ;
Strupp, M .
BRAIN, 2005, 128 :2732-2741
[8]   General vestibular testing [J].
Brandt, T ;
Strupp, M .
CLINICAL NEUROPHYSIOLOGY, 2005, 116 (02) :406-426
[9]  
BRANDT T, 2001, VERTIGO ITS MULTISEN
[10]  
BRONSTEIN AM, 1991, BRAIN, V114, P1