Bilateral Vestibular Hypofunction: Challenges in Establishing the Diagnosis in Adults

Raymond van de Berg*, Mark van Tilburg, Herman Kingma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

66 Citations (Web of Science)


Bilateral vestibular hypofunction (BVH) probably represents a heterogeneous disorder with different types of clinical pictures, with and without vertigo. In spite of increasingly sophisticated electrophysiological testing, still many challenges are met when establishing a diagnosis of BVH. Here, we review the main challenges, which are a reflection of its often difficult clinical presentation and the lack of diagnostic standards regarding the implementation and interpretation of vestibular tests. These challenges show that there is an urgent need for standardization. The resulting decisions should be used for the development of uniform diagnostic criteria for BVH, which are, at present, not yet available.
Original languageEnglish
Pages (from-to)197-218
JournalORL: journal for oto-rhino-laryngology and its related specialties
Issue number4
Publication statusPublished - 2015


  • Bilateral vestibular hypofunction
  • Bilateral vestibulopathy
  • Bilateral vestibular areflexia
  • Bilateral vestibular loss
  • Vestibular implant
  • Vestibular prosthesis
  • Head impulse test
  • Caloric test
  • Rotatory chair tests
  • Vestibulo-ocular reflex

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