Visual vertigo syndrome: clinical and posturography findings.

TLDR

Visual vertigo can be worsened by CNS or strabismic symptoms that impair the ability to resolve sensory conflict, leading to inappropriate postural reactions in visually challenging environments. In a cohort of 15 patients, 13 had peripheral vestibular disorders, 2 had CNS disorders, and 5 exhibited excessive body sway on visual motion posturography; the study concludes that visual vertigo is heterogeneous, arising from peripheral or central causes and linked to high visual field dependence in balance disorders.

Abstract

Neuro-otological and posturography findings in 15 patients with visually induced vertiginous symptoms (visual vertigo) are reported. Thirteen patients were considered to have a peripheral vestibular disorder; seven had abnormal caloric or rotational test results. Two patients had CNS disorder--a cerebellar degeneration and a brainstem stroke. Posturography testing showed that five patients showed abnormally large body sway induced by full field visual motion stimulation. This group included the two patients with CNS disease and four with strabismic symptoms (diplopia, squint surgery, and ocular muscle weakness). It is concluded that visual vertigo is a heterogeneous syndrome with peripheral or central aetiologies and may occur if patients with balance disorders show high visual field dependence. In patients with visual vertigo, the presence of additional CNS or strabismic symptoms may cause inappropriate postural reactions in environments with conflicting or disorienting visual stimuli, probably by reducing the ability to resolve the sensory conflict.