Difficulties Faced by Patients Suffering from Total Bilateral Vestibular Loss

Abstract

A unilateral sudden loss of function generates intense and frightening symptoms urging patients to see a doctor. Generally, the symptoms and signs of the deficit are so obvious that doctors make the diagnosis quickly. The situation is quite different if the deficit is gradual and affects both sides. To better understand the difficulties faced by patients suffering from total bilateral vestibular loss, 19 subjects were interviewed in a semistructured talk. The discussion focused on five main topics: (1) symptoms, (2) the medical trajectory from the earliest symptoms to the diagnosis, (3) the prescribed treatments, (4) the impact of the disease on work, and (5) the impact on social functioning and recreational activities. The symptoms reported by patients are insidious, and they may suggest a neurological deficit or a cardiocirculatory or psychiatric disorder. The diagnosis is often made after several consultations with several doctors from different specialties. When the diagnosis is made, all kinds of treatment are undertaken, in particular vestibular rehabilitation. Indeed, most physicians believe that it can promote central compensation processes, even though it has been demonstrated that vestibular exercises are ineffective in most of these patients. Two thirds of our subjects were obliged to modify or even stop their professional activities due the bilateral vestibular loss. In some patients, the disability is such that they almost constantly require the presence of their spouse. In conclusion, the symptoms of bilateral vestibular loss are sometimes misleading. They are often not recognized by doctors. The deficit has an obvious impact on patients' social functioning and professional activities.