Bilateral Vestibular Hypofunction (BVH)

Stanford Dizziness Clinic

Background

Bilateral Vestibular Hypofunction (BVH) occurs when both inner ears lose their ability to send proper balance signals to the brain. This leads to unsteadiness, difficulty walking in the dark or on uneven surfaces, and a sensation of bouncing vision (oscillopsia) during head movement. Unlike other vestibular disorders, BVH typically does not cause spinning vertigo.

Causes

BVH can result from certain medications (such as aminoglycoside antibiotics), autoimmune conditions, genetic disorders, Meniere’s Disease, or chronic vestibular dysfunction. In 50% of cases, the cause is unknown.

Treatment

Treatment focuses on vestibular rehabilitation therapy to improve balance and visual stability. Patients benefit from strength training, structured exercise, and compensatory strategies like using trekking poles for stability. In severe cases, vestibular implants are being researched as a future treatment option. There is no cure for this disease. Symptoms can be improved but rarely fully resolved.