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Vertigo and Dizziness pp 41–87Cite as

Peripheral Vestibular Forms of Vertigo

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Abstract

Three forms of peripheral vestibular disorders, each with its typical symptoms and clinical signs, can be differentiated:

  • Bilateral peripheral loss of vestibular function (bilateral vestibulopathy). The main symptoms are oscillopsia during head movements (failure of the vestibulo-ocular reflex) and instability of gait and posture. The latter two symptoms increase in darkness and on uneven ground (due to reduced or absent visual or somatosensory information).

  • Acute/subacute unilateral failure of vestibular function (labyrinth and/or vestibular nerve), which causes a vestibular tonus imbalance. Main symptoms are rotatory vertigo (for a few days or weeks), nausea, oscillopsia and a tendency to fall in a certain direction.

  • Inadequate paroxysmal stimulation of the peripheral vestibular system of the labyrinth (e.g., during benign paroxysmal positioning vertigo) or of the vestibular nerve (e.g., during vestibular paroxysmia due to ectopic discharges). The main symptoms are attacks of rotatory or postural vertigo.

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References

  • Baloh RW, Jacobson K, Honrubia V (1993) Horizontal semicircular canal variant of benign positional vertigo. Neurology 43:2542–2549

    PubMed  CAS  Google Scholar 

  • Bertholon P, Bronstein AM, Davies RA et al (2002) Positional down beating nystagmus in 50 patients: cerebellar disorders and possible anterior semicircular canalithiasis. J Neurol Neurosurg Psychiatry 72:366–372

    Article  PubMed  CAS  Google Scholar 

  • Bisdorff AR, Debatisse D (2001) Localizing signs in positional vertigo due to lateral canal cupulolithiasis. Neurology 57:1085–1088

    PubMed  CAS  Google Scholar 

  • Brandt T, Daroff RB (1980) Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol 106:484–485

    PubMed  CAS  Google Scholar 

  • Brandt T, Steddin S, Daroff RB (1994) Therapy for benign paroxysmal positioning vertigo, revisited. Neurology 44:796–800

    PubMed  CAS  Google Scholar 

  • Brandt T, Steddin S (1993) Current view of the mechanism of benign paroxysmal positioning vertigo: cupulolithiasis or canalolithiasis? J Vestib Res 3:373–382

    PubMed  CAS  Google Scholar 

  • Büttner U, Brandt T, Helmchen C (1999) Diagnostic criteria for central versus peripheral positioning nystagmus and vertigo. Acta Otolaryngol (Stockh) 119:1–5

    Article  PubMed  Google Scholar 

  • Epley JM (1992) The canalith repositioning procedure: for treatment of benign paroxysmal positioning vertigo. Otolaryngol Head Neck Surg 10:299–304

    Google Scholar 

  • Gacek RR (1978) Further observations on posterior ampullary nerve transection for positional vertigo. Ann Otol Rhinol Laryngol 87:300–306

    PubMed  CAS  Google Scholar 

  • Herdman SJ, Tusa RJ, Zee DS et al (1993) Single treatment approaches to benign paroxysmal vertigo. Arch Otolaryngol Head Neck Surg 119:450–454

    PubMed  CAS  Google Scholar 

  • Hilton M, Pinder D (2002) The Epley manoeuvre for benign paroxysmal positional vertigo—a systematic review. Clin Otolaryngol 27:440–445

    Article  PubMed  CAS  Google Scholar 

  • Lempert T, Tiel-Wilck K (1996) A positional maneuver for treatment of horizontal-canal benign positional vertigo. Laryngoscope 106:476–478

    Article  PubMed  CAS  Google Scholar 

  • Levat E, van Melle G, Monnier P, Maire R (2003) Efficacy of the Semont maneuver in benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg 129:629–633

    Article  Google Scholar 

  • McClure JA (1985) Horizontal canal BPV. J Otolaryngol 14:30–35

    PubMed  CAS  Google Scholar 

  • Pace-Balzan A, Rutka JA (1991) Non-ampullary plugging of the posterior semicircular canal for benign paroxysmal positional vertigo. J Laryngol Otol 105:901–906

    PubMed  CAS  Google Scholar 

  • Parnes ES, McClure JA (1991) Posterior semicircular canal occlusion in normal hearing ear. Otolaryngol Head Neck Surg 104:52–57

    PubMed  CAS  Google Scholar 

  • Radtke A, von Brevern M, Tiel-Wilck K et al (2004) Self-treatment of benign paroxysmal positional vertigo—Semont maneuver vs Epley procedure. Neurology 63:150–152

    PubMed  CAS  Google Scholar 

  • Schuknecht HF (1969) Cupulolithiasis. Arch Otolaryngol 90:765–778

    PubMed  CAS  Google Scholar 

  • Semont A, Freyss G, Vitte E (1988) Curing the BPPV with a liberatory manoeuvre. Adv Otorhinolaryngol 42:290–293

    PubMed  CAS  Google Scholar 

  • Steddin S, Brandt T (1996) Horizontal canal benign paroxysmal positioning vertigo (h-BPPV): transition of canalolithiasis to cupulolithiasis. Ann Neurol 40:918–922

    Article  PubMed  CAS  Google Scholar 

  • Strupp M, Brandt T, Steddin S (1995) Horizontal canal benign paroxysmal positioning vertigo: reversible ipsilateral caloric hypoexcitability caused by canalolithiasis? Neurology 45:2072–2076

    PubMed  CAS  Google Scholar 

  • Vanucchi P, Giannoni B, Pagnini P (1997) Treatment of horizontal semicircular canal benign paroxysmal positional vertigo. J Vestib Res 7:1–6

    Article  Google Scholar 

References

  • Andrews JC, Hoover LA, Lees RS, Honrubia V (1988) Vertigo in the hyperviscosity syndrome. Otolaryngol Head Neck Surg 98:144–149

    PubMed  CAS  Google Scholar 

  • Arbusow V, Schulz P, Strupp M et al (1999) Distribution of herpes simplex virus type I in human geniculate and vestibular ganglia: implications for vestibular neuritis. Ann Neurol 46:416–419

    Article  PubMed  CAS  Google Scholar 

  • Baloh RW, Ishyama A, Wackym PA, Honrubia V (1996) Vestibular neuritis: clinical—pathologic correlation. Otolaryngol Head Neck Surg 114:586–592

    Article  PubMed  CAS  Google Scholar 

  • Brandt T, Strupp M, Arbusow V, Dieringer N (1997) Plasticity of the vestibular system: central compensation and sensory substitution for vestibular deficits. Adv Neurol 73:297–309

    PubMed  CAS  Google Scholar 

  • Brandt T (1999) Vertigo: its multisensory syndromes, 2nd edn. Springer, London

    Google Scholar 

  • Büchele W, Brandt T (1988) Vestibular neuritis, a horizontal semicircular canal paresis? Adv Otorhinolaryngol 42:157–161

    PubMed  Google Scholar 

  • Cawthorne T (1944) The physiological basis for head exercises. J Chart Soc Physiother 30:106–107

    Google Scholar 

  • Curthoys S (2000) Vestibular compensation and substitution. Curr Opin Neurol 13:27–30

    Article  PubMed  CAS  Google Scholar 

  • Fetter M, Dichgans J (1996) Vestibular neuritis spares the inferior division of the vestibular nerve. Brain 119:755–763

    Article  PubMed  Google Scholar 

  • Gacek RR, Gacek MR (2002) The three faces of vestibular ganglionitis. Ann Otol Rhinol Laryngol 111:103–114

    PubMed  Google Scholar 

  • Halmagyi GM, Curthoys IS (1988) A clinical sign of canal paresis. Arch Neurol 45:737–738

    PubMed  CAS  Google Scholar 

  • Halmagyi GM, Aw ST, Karlberg M, Curthoys IS, Todd MJ (2002) Inferior vestibular neuritis. Ann NY Acad Sci 956:306–313

    Article  PubMed  CAS  Google Scholar 

  • Hamann KF (1988) Rehabilitation von Patienten mit vestibulären Störungen. HNO 36:305–307

    PubMed  CAS  Google Scholar 

  • Herdman SJ (2000) Vestibular rehabilitation, 2nd edn. FA Davis Co, Philadelphia

    Google Scholar 

  • Igarashi M (1986) Compensation for peripheral vestibular disturbances—animal studies. In: Bles W, Brandt T (eds) Disorders of posture and gait. Elsevier, Amsterdam, pp 337–351

    Google Scholar 

  • Jerram A, Darlington CL, Smith PF (1995) Methylprednisolone reduces spontaneous nystagmus following unilateral labyrinthectomy in guinea pig. Eur J Pharmacol 275:291–293

    Article  PubMed  CAS  Google Scholar 

  • McCabe BF (1989) Autoimmune inner ear disease: therapy. Am J Otol 10:196–197

    PubMed  CAS  Google Scholar 

  • Murofushi T, Monobe H, Ochiai A, Ozeki H (2003) The site of lesion in “vestibular neuritis”: study by galvanic VEMP. Neurology 61:417–418

    PubMed  Google Scholar 

  • Nadol JB Jr (1995) Vestibular neuritis. Otolaryngol Head Neck Surg 112:162–172

    Article  PubMed  Google Scholar 

  • Okinaka Y, Sekitani T, Okazaki H et al (1993) Progress of caloric response of vestibular neuronitis. Acta Otolaryngol (Stockh) Suppl 503:18–22

    Google Scholar 

  • Orsoni JG, Zavota L, Pellistri I et al (2002) Cogan syndrome. Cornea 21:356–359

    Article  PubMed  Google Scholar 

  • Rosenhall U, Hanner P, Kaijser B (1988) Borrelia infection and vertigo. Acta Otolaryngol (Stockh) 106:111–116

    PubMed  CAS  Google Scholar 

  • Schuknecht HF, Kitamura K (1981) Vestibular neuritis. Ann Otol Rhinol Otolaryngol 90:Suppl 78:1–19

    CAS  Google Scholar 

  • Strupp M, Arbusow V, Brandt T (2001) Exercise and drug therapy alter recovery from labyrinth lesion in humans. Ann NY Acad Sci 942:79–94

    Article  PubMed  CAS  Google Scholar 

  • Strupp M, Arbusow V, Maag KP et al (1998) Vestibular exercises improve central vestibulo-spinal compensation after vestibular neuritis. Neurology 51:838–844

    PubMed  CAS  Google Scholar 

  • Strupp M, Zingler V, Arbusow V et al (2004) Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 341:354–361

    Article  Google Scholar 

  • Theil D, Arbusow V, Derfuss T et al (2001) Prevalence of HSV-1 LAT in human trigeminal, geniculate, and vestibular ganglia and its implication for cranial nerve syndromes. Brain Pathol 11:408–413

    Article  PubMed  CAS  Google Scholar 

  • Theil D, Derfuss T, Strupp M, Gilden DH, Arbusow V, Brandt T (2002) Cranial Nerve Palsies: Herpes Simplex Virus Type 1 and Varizella-Zoster Virus Latency. Ann Neurol 51:273–274

    Article  PubMed  Google Scholar 

  • Thömke F, Hopf HC (1999) Pontine lesions mimicking acute peripheral vestibulopathy. J Neurol Neurosurg Psychiatry 66:340–349

    PubMed  Google Scholar 

  • Vollertsen RS, McDonald T, Younge BR et al (1986) Cogan’s syndrome: 18 cases and a review of the literature. Mayo Clin Proc 61:344–361

    PubMed  CAS  Google Scholar 

  • Yamanaka T, Sasa M, Amano T et al (1995) Role of glucocorticoids in vestibular compensation in relation to activation of vestibular nucleus neurons. Acta Otolaryngol (Stockh) Suppl 519:168–172

    Google Scholar 

  • Zee DS (1985) Perspectives on the pharmacotherapy of vertigo. Arch Otolaryngol 111:609–612

    PubMed  CAS  Google Scholar 

References

  • American Academy of Ophthalmology and Otolaryngology (1995) Committee on Hearing and Equilibrium guidelines for diagnosis and evaluation of therapy in Menière’s disease. Otolaryngol Head Neck Surg 113:181–185

    Article  Google Scholar 

  • Baloh RW, Jacobson K, Winter T (1990) Drop attacks with Menière’s syndrome. Ann Neurol 28:384–387

    Article  PubMed  CAS  Google Scholar 

  • Blakley BW (2000) Update on intratympanic gentamicin for Menière’s disease. Laryngoscope 110:236–240

    Article  PubMed  CAS  Google Scholar 

  • Claes J, van de Heyning PH (1997) Medical treatment of Menière’s disease: a review of literature. Acta Otolaryngol (Stockh) Suppl 526:37–42

    Google Scholar 

  • Friberg U, Stahle J, Svedberg A (1984) The natural course of Menière’s disease. Acta Otolaryngol (Stockh) Suppl 406:72–77

    Google Scholar 

  • James A, Thorp M (2001) Menière’s disease. Clinical Evidence 5:348–355

    Google Scholar 

  • Magnusson M, Padoan S, Karlberg M, Johansson R (1991) Delayed onset of ototoxic effects of gentamicin in treatment of Menière’s disease. Acta Otolaryngol (Stockh) Suppl 481:610–612

    Google Scholar 

  • Meyer ED (1985) Zur Behandlung des Morbus Menière mit Betahistinmesilat (Aequamen)—Doppel-blindstudie gegen Placebo (cross over). Laryng Rhinol Otol 64:269–272

    CAS  Google Scholar 

  • Morrison AW (1986) Predictive test for Menière’s disease. Am J Otol 7:5–10

    PubMed  CAS  Google Scholar 

  • Ödkvist LM, Bergenius J (1988) Drop attacks in Menière’s disease. Acta Otolaryngol (Stockh) Suppl 455:82–85

    Google Scholar 

  • Radtke A, Lempert T, Gresty MA et al (2002) Migraine and Menière’s disease: is there a link? Neurology 59:1700–1704

    PubMed  CAS  Google Scholar 

  • Sade J, Yaniv E (1984) Menière’s disease in infants. Acta Otolaryngol (Stockh) 97:33–37

    PubMed  CAS  Google Scholar 

  • Schuknecht HF, Gulya AJ (1983) Endolymphatic hydrops: an overview and classification. Ann Otol 92(Suppl. 106):1–20

    Google Scholar 

  • Stahle J, Stahle C, Arenberg IK (1978) Incidence of Menière’s disease. Arch Otolaryngol 104:99–102

    PubMed  CAS  Google Scholar 

  • Thomson J, Bretlau M, Tos M, Johnson J (1981) Placebo effect in surgery of Menière’s disease. Arch Otolaryngol 107:271–277

    Google Scholar 

  • Van Cauwenberge PB, De Moor SEG (1997) Physiopathology of H3-receptors and pharmacology of betahistine. Acta Otolaryngol (Stockh) 526:43–46

    Google Scholar 

  • Yabe T, de Waele C, Serafin M et al (1993) Medial vestibular nucleus in guinea-pig: histaminergic receptors. Exp Brain Res 93:249–258

    Article  PubMed  CAS  Google Scholar 

References

  • Arbusow V, Strupp M, Dieterich M, Brandt T (1998) Alternating episodes of vestibular nerve excitation and failure. Neurology 51:1480–1483

    PubMed  CAS  Google Scholar 

  • Brandt T, Dieterich M (1994) Vestibular paroxysmia: vascular compression of the 8th nerve? Lancet 343:798

    Article  PubMed  CAS  Google Scholar 

  • Buettner U, Stöhr M, Koletzki E (1983) Brainstem auditory-evoked potential abnormalities in vascular malformation of the posterior fossa. J Neurol 229:247–254

    Article  PubMed  CAS  Google Scholar 

  • Jannetta PJ (1975) Neurovascular cross-compression in patients with hyperactive dysfunction symptoms of the eighth cranial nerve. Surg Forum 26:467–468

    PubMed  CAS  Google Scholar 

  • Jannetta PJ, Møller MB, Møller AR (1984) Disabling positional vertigo. N Engl J Med 310:1700–1705

    Article  PubMed  CAS  Google Scholar 

  • Møller MB, Møller AR, Jannetta PJ, Sekhar L (1986) Diagnosis and surgical treatment of disabling positional vertigo. J Neurosurgery 64:21–28

    Article  Google Scholar 

  • Møller MB (1988) Controversy in Menière’s disease: results of microvascular decompression of the eighth nerve. Am J Otol 9:60–63

    PubMed  Google Scholar 

  • Straube A, Büttner U, Brandt T (1994) Recurrent attacks with skew deviation, torsional nystagmus, and contraction of the left frontalis muscle. Neurology 44:177–178

    PubMed  CAS  Google Scholar 

  • Yousry I, Dieterich M, Naidich TP et al (2002a) Superior oblique myokymia: magnetic resonance imaging support for the neurovascular compression hypothesis. Ann Neurol 51:361–368

    Article  PubMed  Google Scholar 

  • Yousry I, Moriggl B, Dieterich M et al (2002b) MR anatomy of the proximal cisternal segment of the trochlear nerve: neurovascular relationships and landmarks. Neuroradiology 223:31–38

    Google Scholar 

  • Yu Y, Moseley I, Pullicino P (1982) The clinical picture of ectasia of the intracerebral arteries. J Neurol Neurosurg Psychiatry 45:29–36

    PubMed  CAS  Google Scholar 

References

  • Arbusow V, Strupp M, Dieterich M et al (1998) Serum antibodies against membranous labyrinth in patients with “idiopathic” bilateral vestibulopathy. J Neurol 245:132–136

    Article  PubMed  CAS  Google Scholar 

  • Brandt T (1996) Bilateral vestibulopathy revisited. Eur J Med Res 1:361–368

    PubMed  CAS  Google Scholar 

  • Brandt T (1999) Vertigo: its multisensory syndromes, 2nd edn. Springer, London

    Google Scholar 

  • Halmagyi GM, Curthoys IS (1988) A clinical sign of canal paresis. Arch Neurol 45:737–739

    PubMed  CAS  Google Scholar 

  • Herdman SJ (2000) Vestibular rehabilitation, 2nd edn. FA Davis Co, Philadelphia

    Google Scholar 

  • Magnusson M, Enbom H, Pyykko I (1991) Postural compensation of congenital or early acquired vestibular loss in hearing disabled children. Acta Otolaryngol (Stockh) Suppl 481:433–435

    Google Scholar 

  • Orsoni JG, Zavota L, Pellistri I et al (2002) Cogan syndrome. Cornea 21:356–359

    Article  PubMed  Google Scholar 

  • Rinne T, Bronstein AM, Rudge P et al (1995) Bilateral loss of vestibular function. Acta Otolaryngol (Stockh) Suppl 520:247–250

    Google Scholar 

  • Schautzer F, Hamilton D, Kalla R et al (2003) Spatial memory deficits in patients with chronic bilateral vestibular failure. Ann NY Acad Sci 1004:316–324

    Article  PubMed  Google Scholar 

  • Schüler O, Strupp M, Arbusow V, Brandt T (2003) A case of possible autoimmune bilateral vestibulopathy treated with steroids. J Neurol Neurosurg Psychiatry 74:825

    Article  PubMed  Google Scholar 

  • Smith PF (1997) Vestibular-hippocampal interactions. Hippocampus 7:465–471

    Article  PubMed  CAS  Google Scholar 

  • Vibert D, Liard P, Häusler R (1995) Bilateral idiopathic loss of peripheral vestibular function with normal hearing. Acta Otolaryngol (Stockh) 115:611–615

    PubMed  CAS  Google Scholar 

References

  • Dieterich M, Brandt T, Fries W (1989) Otolith function in man: results from a case of otolith Tullio phenomenon. Brain 112:1377–1392

    Article  PubMed  Google Scholar 

  • Minor LB, Cremer PD, Carey JP et al (2001) Symptoms and signs in superior canal dehiscence syndrome. Ann NY Acad Sci 942:259–273

    Article  PubMed  CAS  Google Scholar 

  • Minor LB, Solomon D, Zinreich JS, Zee DS (1998) Sound-and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg 124:249–258

    PubMed  CAS  Google Scholar 

  • Nomura Y, Okuno T, Hara M, Young YH (1992) “Floating” labyrinth. Pathophysiology and treatment of perilymph fistula. Acta Otolaryngol (Stockh) 112:186–191

    PubMed  CAS  Google Scholar 

  • Singleton GT (1986) Diagnosis and treatment of perilymph fistulas without hearing loss. Otolaryngol Head Neck Surg 94:426–429

    PubMed  CAS  Google Scholar 

  • Strupp M, Eggert T, Straube A et al (2000) Inner perilymph fistula of the anterior semicircular canal. Nervenarzt 71:138–142

    Article  PubMed  CAS  Google Scholar 

  • Watson SR, Halmagyi GM, Colebatch JG (2000) Vestibular hypersensitivity to sound (Tullio phenomenon): structural and functional assessment. Neurology 54:722–728

    PubMed  CAS  Google Scholar 

Download references

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(2005). Peripheral Vestibular Forms of Vertigo. In: Vertigo and Dizziness. Springer, London. https://doi.org/10.1007/1-84628-081-8_2

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  • DOI: https://doi.org/10.1007/1-84628-081-8_2

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  • Print ISBN: 978-1-85233-814-5

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