Patients with acute vestibular loss are unsteady and often veer or fall toward the side of the affected ear for several days after the event.
Walking requires proprioceptive, visual and vestibular afferent information in addition to normal motor function.
Degenerative changes occur with age in the visual, vestibular, motor, sensory and cerebellar systems.
The sensation of orientation is made possible by cortical-subcortical mechanisms, including the vestibular system.
Some patients show improvement in vestibular function after ototoxic drugs are discontinued, but often the damage is irreversible.
Although vestibular input will eventually counteract the reflex, post-operative tilts in excess of 60 degrees were common.
Vestibular function can also be assessed at the bedside.
The most common identifiable cause of bilateral vestibular loss is ototoxic drug exposure.
