7.2 Bilateral Peripheral Vestibular Loss. (15 SSB)

Age at test: 38

Key Signs:

Knowledge of the pattern of balance control for this patient with a long-term loss is important when considering results of patients simulating a balance problem. Clearly this patient has compensated well but still has difficulties with control of trunk pitch standing eyes closed (see traces below). Note how the patient really tries to rapidly correct his backwards falling (pitch trace deflection downwards). Both pitch and roll velocity are abnormal. Contrast this with patient results for a non organic disorder, case 7.4 below. The simulator slowly falls forward in the pitch direction only (see case below). Test results for 1-legged stance in the bilateral loss patient also indicate instability. Trunk pitch velocity when walking, eyes closed, and roll angle when walking up and down stairs are borderline normal.

Standing on two legs, eyes closed, on foam.

Analysis Data:

The patients values on the left indicate the instability standing eyes closed on foam. Both pitch and roll values are greater than normal, pitch more so.

Summary Data:

The sensory analysis ratio “vestibular” clearly indicates a deficiency in the use of vestibular balance control signals. Rehabilitation should concentrate on improving balance control during difficult gait tasks.

Indexes:

Confirms this classical type of balance deficit as the patient has a value outside the normal reference range.