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The Egyptian Journal of Otolaryngology
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Visual vestibular mismatch: is it a vestibular disorder?

The Egyptian Journal of Otolaryngology volume 33, pages 645–649 (2017)Cite this article

Abstract

Background

Visual vestibular mismatch (VVM) is a group of symptoms rather than a disease. All are exaggerated by introducing any visual conflict. For such reason, there is no adequate tools to investigate or to diagnose and limited research studies were done to explore such group of people.

Aim

To identify VVM disorder among dizzy patients and to study the vestibular function in them.

Patients and methods

This study was conducted on 30 patients suffering from VVM (out of 153 patients) who were selected by a questionnaire modified by the authors based on the original questionnaire. All patients were subjected to objective testing including: full neuro-otological history, office vestibular tests including dynamic visual test (DVA), modified clinical test of sensory integration of balance (MCTSIB), Fukuda stepping test, functional reach test, videonystagmography and vestibular evoked myogenic potentials (VEMPs).

Results

VVM symptomatology was found in 19 patients (subjectively by Mallison questionnaire) and reached 30 patients using a modified questionnaire. 23.33% patients had abnormal Fukuda test, 26.6% had abnormal functional reach test, while 97.6% of patients had abnormal MCTSIB test scores and 50% had abnormal DVA test scores. Abnormal cervical VEMP test results were present in 50% of cases, while only 10% suffered from videonystagmography abnormalities reflecting minor affection of semicircular canals as compared with the saccule.

Conclusion

This study showed that VVM is a fairly common complain among the dizzy population and it can be easily picked up using a simple questionnaire. Office tests as DVA and MCTSIB were highly sensitive tests for VVM patients but more research is needed to find the correlations between these tests and VVM. The study pointed out to the importance of cervical VEMP test to be routinely enrolled in testing of patients with suggestive symptoms of VVM. Further researches should be conducted for knowing the underlying cause and the exact role of saccule in VVM.

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Authors and Affiliations

  1. Audiology Unit, ENT Department, Audiovestibular Medicine, Ain Shams University, Cairo, Egypt

    Nadia Kamal, Hesham Taha & Rasha H. El-Kabarity (MD)

  2. Audiology Unit, ENT Department, Suez Canal University, Ismailia, Egypt

    Dina Housni

Authors
  1. Nadia Kamal
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  2. Hesham Taha
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  3. Rasha H. El-Kabarity
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  4. Dina Housni
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Corresponding author

Correspondence to Rasha H. El-Kabarity.

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Kamal, N., Taha, H., El-Kabarity, R.H. et al. Visual vestibular mismatch: is it a vestibular disorder?. Egypt J Otolaryngol 33, 645–649 (2017). https://doi.org/10.4103/ejo.ejo_69_17

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  • DOI: https://doi.org/10.4103/ejo.ejo_69_17

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