Bilateral vestibular failure as a unique presenting sign in carcinomatous meningitis: case report Academic Article uri icon

abstract

  • Bilateral vestibular failure is a rare, often unrecognised, clinical entity (0.6%–2% of all routinely performed electronystagmography), characterised by unsteadiness of gait and oscillopsia during head movements. 1 The unsteadiness is due to loss of the vestibulospinal reflexes. It increases in darkness or when walking on uneven or soft ground—that is, when visual and somatosensory inputs, necessary for vestibular substitution, get compromised. Oscillopsia is an illusory movement of a stationary surrounding which occurs typically during locomotion as a result of a retinal slip due to an insufficient vestibulo-ocular reflex. The diagnosis of bilateral vestibular failure can be supported clinically by the finding of an abnormal visuo-ocular reflex (doll's eyes), and an abnormal gaze fixation with compensatory saccades during rapid head turns (the head thrust test). A bithermal caloric test or a …

publication date

  • May 1, 2001