Subjective Visual Vertical in Idiopathic Bilateral Vestibular Hypofunction: Enhanced Role of Vision, Neck, and Body Proprioception

Introduction: We aimed to study the participation of proprioceptive and visual inputs in subjective visual vertical (SVV) in bilateral vestibular hypofunction and in normal subjects. Study Design: Prospective case-control study. Setting: Tertiary referral center. Materials and Methods: SVV (six replicates) was measured on a tiltable rehabilitation seat in 26 adult patients with idiopathic bilateral vestibular hypofunction (IBVH) and 33 adult controls. Subjects were asked to place vertically a 45 degrees-tilted red line on a screen (three replicates to left and three to right alternatively) using a remote control in total darkness and in seven body positions: vertical, head, and body left- and right-tilts to 12 and 24 degrees, and then body left- and right-tilt to 24 degrees with the head upright. Results: In the vertical position, SVV did not differ between IBVH and controls. Patients with IBVH were more sensitive to body tilt than controls (SVV: −8.1 ± 4.66 degrees for IBVH versus −0.2 ± 3.23 for control at 24 degrees body and head left-tilt, p 

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