The severity of unilateral peripheral vestibular dysfunction and outcome in an adult Maltese cohort

Abstract

Symptomatic recovery following unilateral peripheral vestibular dysfunction (uPVD) is variable. The aim was to evaluate recovery as judged by the Dizziness Handicap Inventory (DHI), clinical dynamic visual acuity test (cDVAT) and the instrumented modified clinical test of sensory interaction on balance (ImCTSIB), with respect to the severity of canal paresis in patients with uPVD, seen at the state hospital‟s Dizziness Clinic in Malta. The objectives were to obtain reference values of canal paresis and scores pertaining to the cDVAT, ImCTSIB, and the DHI, and to compare them with those obtained from two groups of patients with uPVD; one group with a canal paresis between 20% to 50% and the other >50%. The study type was causal comparative using a cross-sectional design. A total of 45 subjects were recruited; 29 with uPVD and 16 healthy controls. Those with uPVD were categorised in terms of their degree of canal paresis (mild canal paresis ≥ 20% to 50%, n=16; severe canal paresis >50%, n=13). The DHI, cDVAT and ImCTSIB scores were compared among the three groups. The only significant difference found was that between the control group and the mild and severe canal paresis groups respectively with respect to all DHI scores (p<.05). The total, physical, and functional DHI scores were highest (worst) in the mild canal paresis group, while condition 4 of the ImCTSIB and the horizontal and vertical cDVAT scores were greatest (worst) in the severe canal paresis group. No significant differences were detected using canal paresis cut-off values of 30%, 40%, 60%, 70%, 80% or 90%. The findings suggest that the degree of canal paresis might not be a strong prognostic factor.