Unilateral Vestibular Loss Due to Systemically Administered Gentamicin

  title={Unilateral Vestibular Loss Due to Systemically Administered Gentamicin},
  author={Rebekah M. Ahmed and Hamish G. MacDougall and G{\'a}bor Michael Halm{\'a}gyi},
  journal={Otology \& Neurotology},
Objective: To report the little known fact that systemically administered gentamicin can cause severe unilateral, rather than only bilateral vestibular loss. Methods: This is a retrospective review of patients presenting with imbalance and oscillopsia due to a compensated, selective unilateral vestibular loss, who denied ever experiencing vertigo, but who had been administered systemic gentamicin during a hospital admission just before their symptoms began. Results: From 1993 to 2011, 18 such… 
Gentamicin vestibulotoxicity with modern systemic dosing regimens: a prospective study using video-oculography
Gentamicin may cause reversible, asymptomatic vestibulotoxicity in patients treated with gentamicin, and video-oculography may be useful to monitor for vestibular loss in patients treating with gentamcin; however, testing all patients routinely may be challenging.
Systemic Aminoglycosides-Induced Vestibulotoxicity in Humans
Video Head Impulse test and vestibular evoked myogenic potential testing seem more promising for the early detection of vestibulotoxic side effects than caloric and rotatory testing.
Sensorineural deafness following routine transurethral resection of the prostate
A man in his 50s presented to a rural Australian emergency department with complete unilateral hearing loss following transurethral resection of the prostate and a working diagnosis of gentamicin-induced ototoxicity was applied.
Treatment of vertigo and postural instability using visual illusions
Computer-aided rehabilitation programmes might represent an important advance in gait and posture training for peripheral vestibular disease and show a great improvement in the patient's Dizziness Handicap Inventory score.
Neuro-otology- some recent clinical advances
Recent interesting and important advances in diagnosis of vestibular disorders using the video head impulse test and in the management of benign positional vertigo and migrainous vertigo are reviewed.


A report of two cases of unilateral vestibulopathie after systemic ototoxic treatment.
The existence of unilateral vestibular loss was an unsuspected finding but after careful bedside examination, it was confirmed through extensive Vestibular testing, and this infrequent finding responded very well to vestIBular rehabilitation.
Unilateral vestibulotoxicity due to systemic gentamicin therapy.
6 patients presenting with ataxia and oscillopsia, but without a history of vertigo, who had severe unilateral loss of vestibular function on caloric testing are reported, supported by the observation that Vestibular hair cells can regenerate after aminoglycoside damage.
Permanent Gentamicin Vestibulotoxicity
  • F. O. Black, S. Pesznecker, Valerie L. Stallings
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2004
Serum gentamicin levels are of no value in predicting the onset, occurrence, or severity of vestibulotoxicity or cochleotoxicity.
Recovery from Vestibular Ototoxicity
  • F. O. Black, C. Gianna-Poulin, S. Pesznecker
  • Medicine
    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
  • 2001
Recovery of GC after vestibular ototoxicity is more commonly observed than recovery of TC, and it is proposed that once ototoxic changes in vestibulo-ocular reflex are detected, otot toxic medications should be discontinued as soon as possible.
Vestibular function after acute vestibular neuritis.
The persistent loss of balance that some patients experience after acute Vestibular neuritis can be due to inadequate central compensation or to incomplete peripheral recovery and vestibular rehabilitation has a role in the treatment of both.
The Outcome of Vestibular Nerve Section for Intractable Vertigo: The Patient's Point of View
The development and application of objective preoperative measures of vestibular and, in particular, vestibulospinal function might improve patient selection for Vestibular nerve section and thus reduce the number of dissatisfied patients.
Gentamicin Vestibulotoxicity
It is concluded that as far as the vestibular system is concerned there is no safe gentamicin dose and no safe serum Gentamicin level, and there is an increased risk of vestibulotoxicity in patients in whom nephrotoxicity develops.
Horizontal head impulse test detects gentamicin vestibulotoxicity
Head impulse testing is useful for early bedside detection of gentamicin vestibulotoxicity because most patients, even those with partial bilateral vestibular loss (BVL), have large overt saccades.
Hearing loss in patients with vestibulotoxic reactions to gentamicin therapy.
Patients with vestibulotoxic reactions to gentamicin therapy have little additional hearing loss compared with the general population, and Physicians should monitor both auditory and audiometric function when aminoglycosides, especially gentamicine, must be used.
The video head impulse test
The video head impulse test is equivalent to search coils in identifying peripheral vestibular deficits but easier to use in clinics, even in patients with acute Vestibular neuritis.