I found some information online which seems to add to the evidence that I have bilateral vestibular hypofunction. I found a study that suggests an abnormal ocular counter roll test can be indicative of a hypofunction just like abnormal nystagmus in other tests. I also found that an issue I recently discovered I may have might present in those with a bilateral vestibular hypofunction, Tullio phenomenon without superior canal dehiscence syndrome (SSCD).
In a previous post, I discussed the doctor’s interpretation of my test results. I commented that I figured that the ocular counter roll could uncover vestibular hypofunction via abnormal eye movements like the VNG since the ocular counter roll test records eye movements that occur when the head is tilted. I decided to ask the doctor this question about this test since he didn’t mention the test in his assessment. He didn’t answer my questions. Later, I was doing some research online and came across this study, “The bedside examination of the vestibulo-ocular reflex (VOR): An update:”. The following quote, emphasis mine, answered my question exactly.
“With an imbalance in otolith and especially utricular pathways, the ocular tilt response (OTR) emerges, consisting of a lateral head tilt, vertical misalignment of the eyes (skew deviation with the eye being higher in the higher orbit) and ocular counterroll (torsion of both eyes with the top poles rotating toward the side of lower eye). There is also a consequent perceptual tilt of the visual world. The OTR reflects a tone imbalance analogous to the spontaneous nystagmus that occurs when there is a tone imbalance between the semicircular canals in each labyrinth.”
With this information, I figured there had to be little doubt that there was a hypofunction on the right side.
I also recently discovered that my vestibular symptoms were worse when listening to music and other sounds with headphones for extended periods of time. I found that the issue occurred even when wearing hearing aids. I did some research and came across the “Tullio phenomenon”. This study, “The Tullio phenomenon: a neurologically neglected presentation”, discusses different patient populations who presented with the phenomenon, including one that I had not expected to find.
“…three patients had bilateral vestibular failure, all three without SSCD”
Could the issues being caused by using my headphones for extended periods of time be a manifestation of the Tullio phenomenon, and could the Tullio phenomenon in my case be caused by bilateral vestibular hypofunction?
When I stopped listening to music throughout the day at work using my headphones, I felt so much better, and I could definitely tell an improvement in how I felt at the end of the work day. I felt like I had more energy where before I would feel much more exhausted in the evenings. I’ve also discovered that using the Bluetooth functionality of my hearing aids instead of headphones when using my computer at work results in fewer symptoms. At this time, I don’t intend to use the Bluetooth functionality for listening to music, but using it seems to work better for things like watching training videos and participating in remote meetings.
I believe there’s little doubt now that I have bilateral vestibular hypofunction. I’ve suspected it highly for quite some time now, but along with my test results and history, these studies help to confirm this suspicion.
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