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Otoconial loss or lack of otoconia – An overlooked or ignored diagnosis of balance deficits


Hegemann, S C A; Bockisch, C J (2019). Otoconial loss or lack of otoconia – An overlooked or ignored diagnosis of balance deficits. Medical Hypotheses, 128:17-20.

Abstract

Hypothesis
Lack of otoconia or otoconial loss may be the major reason for increasing imbalance with age, posttraumatic dizziness and residual dizziness as well as other so far unexplained imbalance affecting probably millions of people.
Background
It is written in every textbook that we need sensation of gravity for stable gait and stance, especially on two legs. Lack of otoconia is known to cause lifelong balance problems in animals. Loss of otoconia is happening in aging humans, like shown by increasing incidence of benign paroxysmal positional vertigo (BPPV) and in histological sections. While hundreds of papers have been published on BPPV, increasing imbalance with age and increasing falls, none has ever described the loss of otoconia as a major reason for this imbalance. Maybe this is due to the problems to proof this hypothesis in an individual patient.
We will explain why otoconial loss may cause dizziness, postural and locomotor instability in patients with no other identifiable cause or in addition to other causes. Several reasons can cause otoconial loss and lead to the described symptoms. We will describe the symptoms and the tests which could in combination support the diagnosis.
Conclusion
Our hypothesis argues for the new diagnosis in many patients with so far undiagnosed or incorrectly or incompletely diagnosed dizziness or imbalance.

Abstract

Hypothesis
Lack of otoconia or otoconial loss may be the major reason for increasing imbalance with age, posttraumatic dizziness and residual dizziness as well as other so far unexplained imbalance affecting probably millions of people.
Background
It is written in every textbook that we need sensation of gravity for stable gait and stance, especially on two legs. Lack of otoconia is known to cause lifelong balance problems in animals. Loss of otoconia is happening in aging humans, like shown by increasing incidence of benign paroxysmal positional vertigo (BPPV) and in histological sections. While hundreds of papers have been published on BPPV, increasing imbalance with age and increasing falls, none has ever described the loss of otoconia as a major reason for this imbalance. Maybe this is due to the problems to proof this hypothesis in an individual patient.
We will explain why otoconial loss may cause dizziness, postural and locomotor instability in patients with no other identifiable cause or in addition to other causes. Several reasons can cause otoconial loss and lead to the described symptoms. We will describe the symptoms and the tests which could in combination support the diagnosis.
Conclusion
Our hypothesis argues for the new diagnosis in many patients with so far undiagnosed or incorrectly or incompletely diagnosed dizziness or imbalance.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > General Medicine
Uncontrolled Keywords:General Medicine
Language:English
Date:1 July 2019
Deposited On:15 Nov 2019 14:38
Last Modified:29 Jul 2020 11:47
Publisher:Churchill Livingstone
ISSN:0306-9877
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.mehy.2019.05.002

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