A report of two cases of unilateral vestibulopathie after systemic ototoxic treatment.

PURPOSE OF THE STUDY

To present the cases of two patients that developed unilateral vestibular hypofunction after systemic treatment with ototoxic agents, although they manifested symptoms more typical of bilateral vestibular hypofunction.

MATERIAL AND METHODS

The patients were seen after having recovered from their initial illnesses, and both of them denied suffering any spells of vertigo, loss of hearing during the treatment or tinnitus.

RESULTS

In both patients, oscillopsia and vestibular ataxia were of varying intensity. Bedside vestibular examination, caloric and rotatory chair testing, and vestibular evoked myogenic potentials were congruent with a complete unilateral loss of vestibular function. Audiometry was normal in one case whereas in the other, there was a moderate bilateral sensorineural loss of hearing that was present before treatment and that did not change during the course of the treatment.

CONCLUSION

The existence of unilateral vestibular loss was an unsuspected finding but after careful bedside examination, it was confirmed through extensive vestibular testing. However, this infrequent finding responded very well to vestibular rehabilitation. Different mechanisms are proposed to explain this phenomenon, although there is still no clear evidence of which may account for the responses observed.