Unilateral or Bilateral weakness

[Cochlear]

Calloric:
No resp at right side at all.
Left 44C: 4.8 deg/sec
Left 10C: 5.8 deg/sec

Is this unilateral weakness or bilateral weakness ?

Finding suggest accute unilateral loss:
weak spont. Ny to the left (in the dark)
Head-impulse test positive to the right
Compass walk - drift to the right.
ADG: normal (10dB)

History:
5 days ago intense vertigo lasting 5 min; two days after that felt instabile
3years ago he felt the same attack of vertigo
15years ago was treated with high doses of Gentamicin, but at that time without any vestibular sy.

now without any sy, and denies oscilopsia.


Could it be bilateral vestibular loss due to Gentamicin, and that now he had Vestibular Neuronitis of the right side, but without usual simptoms because of bilateral weaknes that he already had?

Any other thoughts?

[AcousticS]

I just discuss with a few colleagues.

We can´t some. 

I think this is a central fault, not a bilateral weakness.

Reasons:
- Patient hears normally. (-> central fault)
- Compass walk: drift to the right (-> central fault)
- Intense vertigo lasting 5 min,
Only two days after that felt instabile (-> central fault)

Can this to help you?

[hossam]

of course this caloric test indicates a bilateral weakness
but there is a point that should be made clear
In such case the story as i think was as follows
1- few yeras ago the patient had a right periphral vestibular lesion may be vestibular neuritis
2- as part of central compensation process the left vestibular function has been reduced
i think this patient well benifit much from vestibular rehabilitation