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Treatment of vertigo and postural instability using visual illusions

Published online by Cambridge University Press:  15 October 2014

G van Kerckhoven ,
A Mert  and
J A De Ru
G van Kerckhoven*
Affiliation:
University Medical Centre Utrecht, The Netherlands
A Mert
Affiliation:
Military Rehabilitation Centre Aardenburg, Doorn, The Netherlands
J A De Ru
Affiliation:
Department of Otolaryngology, Central Military Hospital Utrecht, The Netherlands
*
Address for correspondence: Mr G van Kerckhoven, KNO CMH. Lundlaan 1, 3584CX Utrecht, The Netherlands E-mail: [email protected]
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Abstract

Background:

Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current ‘gold standard’ treatment available.

Case report:

A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.

Results:

The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.

Conclusion:

Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

Keywords

Virtual Reality Exposure TherapyHead Impulse TestVestibular DiseasesPostural Balance
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 11 , November 2014 , pp. 1005 - 1007
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Shoair, OA, Nyandege, AN, Slattum, PW. Medication-related dizziness in the older adult. Otolaryngol Clin North Am 2011;44:455–71CrossRefGoogle ScholarPubMed
2Ahmed, RM, MacDougall, AHM, Halmagyi, GM. Unilateral vestibular loss due to systemically administered gentamicin. Otol Neurotol 2011;32:1158–62CrossRefGoogle ScholarPubMed
3Black, FO, Pesznecker, S, Stallings, V. Permanent gentamicin vestibulotoxicity. Otol Neurotol 2004;25:559–69Google Scholar
4Hillier, SL, McDonnell, M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 2011;(16):CD005397CrossRefGoogle ScholarPubMed
5Mert, A. Motion-based equilibrium reprocessing therapy: fundamental and clinical aspects. Thesis. Amsterdam: Free University Amsterdam, 2011Google Scholar
6Whitney, SL, Sparto, PJ, Hodged, LF, Babu, SV, Furman, JM, Redfern, MS. Responses to a virtual reality grocery store in persons with and without vestibular dysfunction. Cyberpsychol Behav 2006;9:152–6CrossRefGoogle ScholarPubMed
7Rábago, CA, Wilken, JM. Application of a mild traumatic brain injury rehabilitation program in a virtual reality environment: a case study. J Neurol Phys Ther 2011;35:185–93CrossRefGoogle Scholar
8Weber, KP, Aw, ST, Todd, MJ, McGarvie, LA, Curthoys, IS, Halmagyi, GM. Horizontal head impulse test detects gentamicin vestibulotoxicity. Neurology 2009;72:1417–24Google Scholar
9Hak, L, Houdijk, H, Steenbrink, F, Mert, A, van der Wurff, P, Beek, PJ et al. Speeding up or slowing down? Gait adaptations to preserve gait stability in response to balance perturbations. Gait Posture 2012;36:260–4Google Scholar
10Cabrera Kang, CM, Tusa, RJ. Vestibular rehabilitation: rationale and indications. Semin Neurol 2013;33:276–85Google Scholar
11Dai, C, Fridman, GY, Chiang, B, Davidovics, NS, Melvin, TA, Cullen, KE et al. Cross-axis adaptation improves 3D vestibulo-ocular reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis. Exp Brain Res 2011;210:595–606Google Scholar
12Winkler, PA, Esses, B. Platform tilt perturbation as an intervention for people with chronic vestibular dysfunction. J Neurol Phys Ther 2011;35:105–15Google Scholar
13Brown, KE, Whitney, SL, Wrisley, DM, Furman, JM. Physical therapy outcomes for persons with bilateral vestibular loss. Laryngoscope 2001;111:1812–17CrossRefGoogle ScholarPubMed
14Brown, KE, Whitney, SL, Marchetti, GF, Wrisley, DM, Furman, JM. Physical therapy for central vestibular dysfunction. Arch Phys Med Rehabil 2006;87:76–81CrossRefGoogle ScholarPubMed
15Bles, W, Bos, JE, de Graaf, B, Groen, E, Wertheim, AH. Motion sickness: only one provocative conflict? Brain Res Bull 1998;47:481–87CrossRefGoogle ScholarPubMed
16Jacobson, GP, Newman, CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg 1990;116:424–7Google Scholar