The Challenge of Vestibular Rehabilitation in a Patient with Bilateral Vestibular Dysfunction Following Surgery: A Case Report

Document Type: Case Report

Authors

1 Department of Audiology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Otolaryngoloy, Sina Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Bilateral vestibular dysfunction (BVD) is an uncommon finding in vestibular assessment, and the combination of BVD and orthopedic problems represents a rare and challenging case for treatment.
 
Case Report:
The patient had several previous back surgeries and received gentamycin after surgery. After 6 months, she experienced continuous dizziness, unsteadiness and oscillopsia. The patient underwent complete vestibular assessment and received an individualized vestibular rehabilitation program for 9 months. She achieved a complete recovery from all symptoms and returned to active social function.
 
Conclusion:
Vestibular rehabilitation could be an effective treatment for complicated cases of BVD. Adaptation exercises may be useful in young patients with BVD.
 

Keywords

Main Subjects


1. Bittar RS, Pedalini ME, Ramalho JR, Carneiro CG. Bilateral vestibular loss after caloric irrigation: clinical application of vestibular rehabilitation. Rev Laryngol Otol Rhinol (Bord). 2005;126:3–6.

2. McGath JH, Barber HO, Stoyanoff S. Bilateral vestibular loss and oscillopsia. J Otolaryngol. 1989;18:218–21.

3. Guinand N, Boselie F, Guyot JP, Kingma H. Quality of life of patients with bilateral vestibulopathy. Ann Otol Rhinol Laryngol. 2012; 121: 471–7.

4. Sun DQ, Ward BK, Semenov YR, Carey JP, Della Santina CC. Bilateral Vestibular Deficiency: Quality of Life and Economic Implications. JAMA Otolaryngol Head Neck Surg. 2014;140:527–34.

5. Guinand N, Pijnenburg M, Janssen M, Kingma H. Visual acuity while walking and oscillopsia severity in healthy subjects and patients with unilateral and bilateral vestibular function loss. Arch Otolaryngol Head Neck Surg. 2012;138:301–6.

6. Zingler VC, Weintz E, Jahn K, Huppert D, Cnyrim C, Brandt T, et al. Causative factors, epidemiology, and follow-up of bilateral vestibulopathy. Ann NY Acad Sci. 2009;1164: 505–8.

7. Ward BK, Agrawal Y, Hoffman HJ, Carey JP, Della Santina CC. Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey. JAMA Otolaryngol Head Neck Surg. 2013;139:803–10.

8. Brown KE, Whitney SL, Wrisley DM, Furman JM. Physical therapy outcomes for persons with bilateral vestibular loss. Laryngoscope.2001;111 (10):1812–7.

9. Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res. 2012;22:283–98.

10. Krebs DE, Gill-Body KM, Riley PO, Parker SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngol Head Neck Surg. 1993;109:735–41.

11. Herdman SJ, Hall CD, Schubert MC, Das VE, Tusa RJ. Recovery of dynamic visual acuity in bilateral vestibular hypofunction. Arch Otolaryngol Head Neck Surg. 2007; 133:383–9.

12. Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S, Daneshi A. Validity and reliability of the Persian version of the dizziness handicap inventory. J Res Med Sci. 2014;19:769–75.

13. Alberts BB, Selen LP, Verhagen WI, Medendorp WP. Sensory substitution in bilateral vestibular a-reflexic patients. Physiol Rep. 2015;3: pii: e12385.

14. Scherer M, Migliaccio AA, Schubert MC. Effect of vestibular rehabilitation on passive dynamic visual acuity. J Vestib Res. 2008;18:147–57.