What is it?

  • Known as Bilateral vestibular hypofunction (BVH) or bilateral vestibular hypofunction (BVL)
  • Loss of balance
  • Difficulty seeing clearly while moving the head
  • Difficulty walking in the dark or on uneven surfaces
  • Unusual sensations in the head when moving it


  • Off balance feeling when standing, walking, lying down, or sitting
  • Loss may be progressive
  • Higher incidence rate of falls
  • Oscillopsia: vision blurring that increases during unpredictable & irregular head movements


  • Considered idiopathic in most cases because underlying cause cannot be identified
  • Ototoxicity: drug or chemical related damage to the inner ear
  • Meningitis
  • Sequential vestibular neuritis
  • Autoimmune disorders
  • Neurofibromatosis
  • Chronic inflammatory peripheral polyneuropathy

Implications on Daily Living

  • Patients with BVH may limit their daily activities due to their loss of balance and vision blurriness
  • Loss of ability to travel
    • Cannot drive
    • Cannot walk in unfamiliar areas without help
  • This can cause patients to become socially isolated


  • Gaze stabilization exercises
  • Exercises to improve postural stability
  • In the future, devices and technologies may used to improve the symptoms of BVH
    • These will focus on improving postural stability rather than improving gaze stability


This is written using the following resources:

“Vestibular Rehabilitation 4th Edition”

Veda Educational Resources