Progressive Vestibular Failure in Childhood

Abstract

Gradual loss of vestibular activity is not associated with symptoms. The classical example of this is the absence of vertiginous episodes in a patient with a cerebello-pontine angle tumour who, on testing, has no caloric response on one side.

Similarly in patients with bilateral vestibular failure, vestibular symptoms do not occur if failure is gradual, as in syphilis (1) or very rapid as long as it is symmetrical, as in aminoglycoside ototoxicity (2). There are a limited number of causes of bilateral vestibular failure in the adult. These include congenital and late acquired syphilis, aminoglycoside ototoxicity, bilateral viral labyrinthitis, rarely head injury, autoimmune audiovestibular disease, Friedreich's and other hereditary ataxias, Waardenburg's disease and other rare syndromes.