Bilateral Balance Function Loss
(Bilateral Vestibulopathy-Oscillopsia)

In Brief

• It is the loss of function of the balance organs in both inner ears; it is a rare balance disorder.

• The main complaint is that the surroundings seem to bounce or shake as the head moves (oscillopsia).

• Walking in the dark or on soft or uneven ground becomes difficult, and vision may blur with head movement.

• Often no cause is found; some medicines, Ménière’s disease, injury and immune system diseases can also cause it.

⚠️ Emergency: If dizziness comes with slurred speech, a drooping face, weakness in an arm or leg, double vision or being unable to walk, do not wait – call 112 (emergency).

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• Bilateral balance function losses are among the rare balance disorders. Unilateral or asymmetric pathologies in the peripheral vestibular system cause vertigo, while bilateral pathologies cause bilateral vestibulopathy (BVP), characterized by loss of the vestibulo-oocular reflex. BVP was first described by Dandy in 1942 in two cases that underwent bilateral vestibular neurectomy. Its prevalence in the general population is approximately 28/100,000.

• BVP is a condition characterized by multiple complaints that negatively affect daily life. The most important of these is the loss of the vestibulo-ocular reflex. Clinically, it is described as "oscillopsia," a sensation of tremor that occurs with movement. In addition, other findings include blurred vision with head movement, difficulty recognizing human faces, loss of spatial memory (navigation), and difficulty walking in the dark and on soft, uneven surfaces.

• Although BVP is mostly idiopathic (of unknown cause), it can occur due to many reasons such as drug toxicity [aminoglycosides (antibiotics), chemotherapeutics (oncological treatment), macrolides (antibiotics), loop diuretics (antihypertensives), etc.], Meniere's disease, tumors (acoustic tumors), trauma, and autoimmune diseases.

• Bilateral balance disorders, such as "oscillopsia," and unilateral balance disorders, such as "vertigo," seriously affect daily life.

 

Research by Assoc. Prof. Mehmet Sürmeli on This Topic

The following studies were published in international peer-reviewed journals.

• Assessing bilateral vestibulopathies: integrating vHIT and DHI for clinical insights and functional outcomes. Sürmeli M, Sürmeli R, Şahin Önder S, et al. Acta Otolaryngol. 2026. PubMed →