What is a Bilateral Vestibular Hypofunction?
A Bilateral Vestibular Hypofunction (BVH) can also been known as a Bilateral Vestibular Loss (BVL) or Bilateral Vestibular Weakness (BVW).
This means there is a reduction in function of vestibular (inner ear) function bilaterally (in both ears). BVH results in difficulty maintaining balance, especially when walking in the dark or on uneven surfaces, and difficulty seeing clearly when the head is moving. This increases the risk of falling and can be incredibly socially isolating.
Signs and Symptoms of BVH
The most common symptom experienced is significant imbalance with a high risk of falls. This imbalance is much worse in the dark or on uneven ground. . Other symptoms that can also be experienced include:
- Difficulty walking
- Blurred vision
- Difficulty focusing when head is moving or when driving
- Vision can jump up and down when moving
- Can sometimes get dizziness
- Sometimes associated with changes in sensation or strength
- Sometimes associated with hearing changes
What causes BVH?
In most cases, BVH is considered to be “idiopathic” because the underlying cause cannot be identified However, BVH can also occur as secondary to a number of different problems including: The diagnosis of a stroke is confirmed using a CT scan or MRI scan of your brain. A review by a neurologist is also performed to diagnose and manage the stroke.
- Medications that damage the inner ear nerve or hair cells
- Inner ear damage that occurs at two different times in your life
- Autoimmune disease, or conditions that cause damage to the inner ear over time
- Meniere’s disease that effects both right and left inner ear
- Acoustic neuromas (benign tumor on the inner ear nerve)
- Meningitis, or swelling of the protective membrane of your brain or spinal cord
- Otosclerosis (a rare condition that causes hearing loss because a small bone, the stapes, cannot move well).
- Other more rare conditions
Vestibular Physiotherapy for BVH
Your Vestibular Physiotherapist will complete a comprehensive assessment of your vestibular and balance systems to aid in diagnosis.
Based on your assessment results, your vestibular physiotherapist will then provide an individualised vestibular rehabilitation program which may include exercises to improve your gaze stability, balance and walking.
It is important to also focus on safety considerations during your rehabilitation program. Your vestibular physiotherapist may teach you how to use a cane or walker to decrease risk for falls and encourage you to pay more attention to your surroundings, feel your feet on the ground, and widen your base of support as well as other falls risk reduction strategies.