Unilateral Vestibular Hypofunction (UVH)

Background

Unilateral Vestibular Hypofunction (UVH) occurs when one inner ear loses its ability to send proper balance signals to the brain. This mismatch between the two sides causes dizziness, imbalance, and sometimes a spinning sensation (vertigo), especially with quick head movements. People with UVH may also experience blurry or bouncing vision during motion (oscillopsia), and symptoms often worsen in the dark or on uneven ground.

Causes

UVH is most commonly caused by viral infections of the inner ear, such as vestibular neuritis or labyrinthitis. Other causes include Meniere’s disease, head trauma, vestibular schwannoma, or complications from inner ear surgery. Reduced blood flow to the inner ear or certain autoimmune conditions can also contribute. In many cases, the exact cause is never identified.

Treatment

Treatment centers on vestibular rehabilitation therapy (VRT), which helps retrain the brain to adapt to the loss of input from one ear. Exercises focus on improving balance, eye-head coordination, and walking stability. Staying active and avoiding long periods of rest are important for recovery. Most patients improve significantly over time, although some may continue to notice mild imbalance in challenging environments. There is no medication to cure UVH, but therapy can greatly reduce symptoms and improve function.