Semin Neurol 2020; 40(01): 040-048
DOI: 10.1055/s-0039-3402066
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Bilateral Vestibular Dysfunction

Sun-Uk Lee
1  Department of Neurology, Korea University Anam Hospital, Seoul, South Korea
Hyo-Jung Kim
2  Research Administration Team, Seoul National University Bundang Hospital, Seongnam, South Korea
Ji-Soo Kim
3  Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea
4  Dizziness Center, Clinical Neuroscience Center, and Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
› Author Affiliations
Funding This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (NRF-2016R1D1A1B04935568).
Further Information

Publication History

Publication Date:
14 January 2020 (online)


Bilateral vestibular dysfunction (BVD) refers to hypofunction of the vestibular nerves or labyrinths on both sides. Patients with BVD present with dizziness, oscillopsia, and unsteadiness, mostly during locomotion, which worsen in darkness or on uneven ground. Although aminoglycoside ototoxicity, Meniere's disease, infection, and genetic disorders frequently cause BVD, the etiology remains undetermined in up to 50% of the patients. The diagnosis of BVD requires both symptoms and documentation of deficient vestibulo-ocular reflex function using head-impulse, bithermal caloric, and rotatory chair tests. Since various neurologic and systemic disorders may present with BVD, clinicians should be cautious not to overlook the symptoms and signs of central nervous system and systemic involvements. Vestibular rehabilitation, application of vibrotactile and auditory feedbacks, and vestibular prosthesis can aid the patients with BVD along with the correction of the underlying causes.

Author Contributions

Dr. Lee wrote the manuscript. Dr. H. J. Kim revised the manuscript. Dr. J. S. Kim designed and conceptualized the study and revised the manuscript.


J. S. Kim serves as an associate editor of Frontiers in Neurology – Neuro-otology and is on the editorial boards of the Journal of Clinical Neurology, Frontiers in Neurology – Neuro-Ophthalmology, Journal of Neuro-Ophthalmology, Journal of Vestibular Research, Journal of Neurology, and Medicine.