2010 BC Guide in Determining Fitness to Drive

Less common peripheral vestibular disorders are described in the following table.DisorderTumarkin’s Otolithic Crisis (drop attacks)Complete bilateral vestibular hypofunction(absence of function)DescriptionSudden, spontaneous fall to theground without prior warningMay result in severe andconstant disequilibrium andmotion sensitivityCentral vestibular disordersCentral vestibular disorders generally arise from underlying persistent medical conditions.Because of this, they are more likely to produce prolonged continuous non-specific dizziness.They are characterized by difficulty in interpretation of vestibular, visual and proprioceptive (theunconscious perception of movement and spatial orientation arising from stimuli within the bodyitself) inputs. Gaze stabilization and posture during locomotion may also be affected.Common persistent medical conditions that can cause persistent central vestibular dysfunctionare: cerebrovascular disease cervical vertigo epilepsy multiple sclerosis normal pressure hydrocephalus paraneoplastic syndromes (a response to the effects of a tumour in the body), and traumatic brain injury.Common episodic medical conditions that are not related to structural brain disease but that maycause central vestibular disorders, and typical episode duration, are shown in the following table.DisordermigrainesPsychogenic vertigo/anxiety(hyperventilation syndrome)Durationa few seconds to hoursa few seconds to hours16.2 Prevalence and incidence of vestibular disordersPeripheral vestibular disorders are more common than central vestibular disorders.Age-related decrements in vestibular function are well documented and are likely due todegeneration at both the central and peripheral level. BPPV is reported as a common underlyingcause of impairments in balance with aging.A 2005 study on the frequency of moderate or severe vertigo and dizziness reported that 36.2%of women and 22.4% of men had experienced vertigo or dizziness at some point in their life.150