Presbyvestibulopathy: Diagnostic criteria Consensus document of the Classification Committee of the Barany Society

Y. Agrawal*, R. Van de Berg, F. Wuyts, L. Walther, M. Magnusson, E. Oh, M. Sharpe, M. Strupp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

This paper describes the diagnostic criteria for presbyvestibulopathy (PVP) of the Classification Committee of the Barany Society. PVP is defined as a chronic vestibular syndrome characterized by unsteadiness, gait disturbance, and/or recurrent falls in the presence of mild bilateral vestibular deficits, with findings on laboratory tests that are between normal values and the thresholds established for bilateral vestibulopathy. The diagnosis of PVP is based on patient history, bedside examination, and laboratory evaluation. The diagnosis of PVP requires bilaterally reduced function of the vestibulo-ocular reflex (VOR). This can be diagnosed for the high frequency range of the VOR with video-HIT (vHIT), for the middle frequency range with rotary chair testing, and for the low frequency range with caloric testing. For the diagnosis of PVP, the horizontal angular VOR gain on both sides should be < .8 and > .6, and/or the sum of the maximal peak velocities of the slow phase caloric-induced nystagmus for stimulation with warm and cold water on each side should be < 25 degrees/s and > 6 degrees/s, and/or the horizontal angular VOR gain should be > .1 and < .3 upon sinusoidal stimulation on a rotatory chair. PVP typically occurs along with other age-related deficits of vision, proprioception, and/or cortical, cerebellar, and extrapyramidal function which also contribute to and might even be required for symptoms of unsteadiness, gait disturbance, and falls to manifest. These criteria simply consider the presence of these symptoms, along with documented impairment of vestibular function, in older adults. (C) 2021 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Otorrinolarin-gologia y Cirugia de Cabeza y Cuello.
Original languageSpanish
Pages (from-to)42-50
Number of pages9
JournalActa Otorrinolaringologica Espanola
Volume73
Issue number1
DOIs
Publication statusPublished - 1 Jan 2022

Keywords

  • Presbyvestibulopathy
  • Diagnosis
  • Criteria
  • AGE-RELATED-CHANGES
  • PAROXYSMAL POSITIONAL VERTIGO
  • QUALITY-OF-LIFE
  • VESTIBULAR FUNCTION
  • NORMATIVE DATA
  • OLDER-ADULTS
  • VESTIBULOOCULAR REFLEX
  • VISUOSPATIAL ABILITY
  • OTOLITH FUNCTION
  • NATIONAL-HEALTH

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