Case 6 — Oscillopsia and falls in the dark

Vignette
A 68-year-old retired engineer describes two years of progressively worse unsteadiness, three falls in the past year (all on uneven ground or in dim light), and 'bouncing' of his visual field when he walks briskly or drives over rough roads. There is no rotational vertigo, no hearing change, and no history of aminoglycoside exposure. Bedside head impulses are abnormal in both directions for lateral canals.

Six-canal vHIT

0100200R latg=0.320100200L latg=0.350100200R antg=0.550100200L antg=0.580100200R postg=0.620100200L postg=0.60

Audiogram

2505001k2k4k8k020406080100120Frequency (Hz)Hearing level (dB HL)○ right× left

Does this patient meet the 2017 Bárány Society diagnostic criteria for bilateral vestibulopathy?

References

  1. Strupp M, Kim JS, Murofushi T, Straumann D, Jen JC, Rosengren SM, Della Santina CC, Kingma H. Bilateral vestibulopathy: diagnostic criteria consensus document of the Classification Committee of the Bárány Society. Journal of Vestibular Research 2017;27:177–89.
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