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1. Full Spectrum of Reported Symptoms of Bilateral Vestibulopathy Needs Further Investigation—A Systematic Review

Author

Florence Lucieer, Stijn Duijn, Vincent Van Rompaey, Angelica Pérez Fornos, Nils Guinand, Jean Philippe Guyot, Herman Kingma, and Raymond van de Berg

Subjects
bilateral vestibulopathy, symptoms, dizziness, vertigo, imbalance, oscillopsia, Neurology. Diseases of the nervous system, RC346-429
Abstract

ObjectiveTo systematically review the symptoms reported by patients with bilateral vestibulopathy (BV) in clinical studies and case reports. This would serve as the first step in establishing a validated patient-reported outcome measures (PROM) for BV.MethodsA search on symptoms reported by patients with BV was performed in PubMed, and all publications covering these symptoms were included. Exclusion criteria comprised reviews and insufficient details about the frequency of occurrence of symptoms.Results1,442 articles were retrieved. 88 studies were included (41 clinical studies, 47 case reports). In consensus, 68 descriptions of symptoms were classified into 6 common and generic symptoms. Frequency of symptoms in clinical studies and case reports were reviewed, respectively; imbalance (91 and 86%), chronic dizziness (58 and 62%), oscillopsia (50 and 70%), and recurrent vertigo (33 and 67%). BV could be accompanied by hearing loss (33 and 43%) and tinnitus (15 and 36%). 15 clinical studies and 10 case reports reported symptoms beyond vestibular and hearing deficits such as limited social activities, depression, concentration, and memory impairment and reduced quality of life in general.ConclusionThe literature on BV symptomatology mainly focuses on classic symptoms such as imbalance and oscillopsia, while only few report additional symptoms such as cognitive memory impairment and performing dual tasks. In fact, none of the reviewed clinical studies and case reports provided a comprehensive overview of BV symptoms. To develop a validated PROM, qualitative research using semi-structured and unstructured interviews is needed to explore the full spectrum of BV symptoms.

Published
2018
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2. Bilateral vestibulopathy : beyond imbalance and oscillopsia

Author

Vincent Van Rompaey, H. Kingma, Floor Lucieer, Nils Guinand, M. Joore, Angelica Perez-Fornos, Stijn Duijn, R. Van Hecke, R. van de Berg, L. van Stiphout, KNO, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Family Medicine, RS: CAPHRI - R6 - Promoting Health & Personalised Care, RS: MHeNs - R3 - Neuroscience, RS: CAPHRI - R2 - Creating Value-Based Health Care, Health Services Research, MUMC+: KIO Kemta (9), MUMC+: MA Keel Neus Oorheelkunde (9), MUMC+: MA Audiologisch Centrum Maastricht (9), and MUMC+: MA Vestibulogie (9)

Subjects
Psychological intervention, Hospital Anxiety and Depression Scale, Outcome measures, 0302 clinical medicine, Quality of life, Epidemiology, Medicine and Health Sciences, IMPLANT, EPIDEMIOLOGY, Prospective Studies, Child, 030223 otorhinolaryngology, Depression (differential diagnoses), Original Communication, Bilateral vestibulopathy, Middle Aged, DEPRESSION, Neurology, CAUSATIVE FACTORS, Child, Preschool, BALANCE, Vertigo, medicine.symptom, Vestibular implant, Adult, medicine.medical_specialty, Bilateral vestibular hypofunction, Adolescent, Vestibular prosthesis, Clinical Neurology, Context (language use), HOSPITAL ANXIETY, Dizziness, Young Adult, 03 medical and health sciences, Oscillopsia, medicine, Humans, Aged, HYPOFUNCTION, business.industry, Infant, medicine.disease, ddc:616.8, Symptoms, Quality of Life, Physical therapy, Neurology (clinical), Human medicine, business, FOLLOW-UP, DIFFICULTIES, 030217 neurology & neurosurgery
Abstract

ObjectiveTo optimize the current diagnostic and treatment procedures for patients with bilateral vestibulopathy (BV), this study aimed to determine the complete spectrum of symptoms associated with BV.MethodA prospective mixed-method study design was used. Qualitative data were collected by performing semi-structured interviews about symptoms, context, and behavior. The interviews were recorded and transcribed until no new information was obtained. Transcriptions were analyzed in consensus by two independent researchers. In comparison to the qualitative results, quantitative data were collected using the Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS) and a health-related quality of life questionnaire (EQ-5D-5L).ResultsEighteen interviews were transcribed. Reported symptoms were divided into fourteen physical symptoms, four cognitive symptoms, and six emotions. Symptoms increased in many situations, such as darkness (100%), uneven ground (61%), cycling (94%) or driving a car (56%). These symptoms associated with BV often resulted in behavioral changes: activities were performed more slowly, with greater attention, or were avoided. The DHI showed a mean score of severe handicap (54.67). The HADS questionnaire showed on average normal results (anxiety = 7.67, depression = 6.22). The EQ-5D-5L demonstrated a mean index value of 0.680, which is lower compared to the Dutch age-adjusted reference 0.839 (60–70 years).ConclusionBV frequently leads to physical, cognitive, and emotional complaints, which often results in a diminished quality of life. Importantly, this wide range of symptoms is currently underrated in literature and should be taken into consideration during the development of candidacy criteria and/or outcome measures for therapeutic interventions such as the vestibular implant.

Published
2020

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