Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease.

OBJECTIVE: To evaluate otolith function by comparing the findings of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential tests in patients in the inter-crisis period of unilateral definite Meniere's disease. METHODS: The sample consisted of an experimental group (n=22; 10 men and 12 women, mean age 47.32±12.82 years) with definite unilateral Meniere's disease and a control group (n=14; 5 men and 9 women, with a mean age of 41.64±13.45 years). They all underwent vestibular evaluation by means of Subjective Visual Vertical with the bucket method and, cervical and ocular Vestibular Evoked Myogenic Potential tests. The data were collected and subjected to statistical analysis. RESULTS: The results of the comparison of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential, the ocular Vestibular Evoked Myogenic Potential and, the association of cervical Vestibular Evoked Myogenic Potential with the ocular Vestibular Evoked Myogenic Potential showed no significant difference, indicating concordance among the tests. CONCLUSION: The identified abnormalities and the concordance between the combined proportion of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential findings indicate that the association of these three tests contributes to the identification of sustained and transient otolith dysfunction in the inter-crisis of unilateral definite Meniere's disease.

Postural Control in Relapsing-Remitting Multiple Sclerosis.

Introduction Postural instability is considered one of the most disabling symptoms of relapsing-remitting multiple sclerosis (RRMS). Objective To evaluate postural control in patients with RRMS. Method A total of 79 individuals between 18 and 65 years old, of both genders, were distributed into an experimental group composed of patients with RRMS ( n = 51) and in a control group composed by healthy individuals ( n = 28). The evaluation consisted of anamnesis, Dizziness Handicap Inventory (DHI), visual vertigo analog scale (VVAS), and static posturography (Tetrax IBS). Results Patients with RRMS presented mild degree in the DHI and in the VVAS; in Tetrax IBS, they presented higher or lower values of the indices of general stability, weight distribution, synchronization of postural oscillation, fall risk, and frequency bands of postural oscillation in two, five or all eight sensory conditions, in relation to the control group. Vestibular, visual and/or somatosensory dysfunction of peripheral type (51.0%) prevailed over the central type. The RRMS group, with an expanded scale of disability status > 3 points, presented a higher fall risk than with a score ≤ 3 points ( p = 0.003). There was a positive correlation of the Fall Risk Index with the total DHI Score (s = 0.380; p = 0.006) and with the VVAS score (s = 0.348; p = 0.012). Conclusion Patients with RRMS may present with inability to maintain postural control due to general instability, desynchronization and increased postural oscillation at frequencies that suggest deficiencies in the vestibular, visual, and somatosensory systems; as well as fall risk related to the state and intensity of functional disability and self-perception of the influence of dizziness on quality of life.

Postural control at posturography with virtual reality in the intercritical period of vestibular migraine.

INTRODUCTION: Vestibular migraine is a condition that associates headache and vestibular symptoms. OBJECTIVE: To evaluate body-balance with virtual reality posturography in vestibular migraine. METHODS: A total of 26 patients in the intercritical period of vestibular migraine were compared by means of the Balance Rehabilitation UnitMT (Medical/Interacoustics) posturography with 30 controls, paired for age and gender. RESULTS: There was no significant statistical difference (p = 0.121) in the limit of stability area (cm2) between the experimental group and the control group values. There were significant differences (p < 0.05) in the values of sway velocity (cm/s) in nine of ten evaluated sensory conditions and in the pressure center displacement area (cm2) values in eight of those ten sensory conditions in the comparison between the control group and the experimental group. CONCLUSION: Posturography with virtual reality can identify changes in the sway velocity and the pressure center displacement area, characterizing the inability to maintain postural control with and without visual deprivation in situations of visual conflict and vestibulovisual interaction,in the intercritical period of the vestibular migraine.

A quantitative analysis of postural control in elderly patients with vestibular disorders using visual stimulation by virtual reality.

INTRODUCTION: Postural instability is one the most common disabling features in vestibular disorders. OBJECTIVE: This study aimed to analyze the limit of stability and the influence of manipulation of visual, somatosensorial and visual-vestibular information on postural control in older adults with vestibular disorder, with and without a history of falls. METHODS: Cross-sectional study. Participants - 76 elderly patients with vestibular disorder (G1, without falls; G2, with falls) and 41 healthy elderly subjects (control group; CG). Using posturography, analyzed were limit of stability area, body center of pressure, and velocity of oscillation in the standing position in 10 conditions, including open/closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual-vestibular interaction. RESULTS: Limit of stability area in CG was better compared with G1-2, and center of pressure values were worse in G1 than in CG. Center of pressure area in all conditions and velocity of oscillation in the following conditions: open/closed eyes, optokinetic stimulation, and visual-vestibular interaction showed worse values in G2 than in CG. Center of pressure area in the following conditions: open/closed eyes, saccadic and optokinetic stimuli, visual-vestibular interaction, and unstable surface with eyes closed showed worse values in G2 than in G1. CONCLUSION: Older adults with vestibular disorder presented reduced limit of stability and increased postural sway in the following conditions: conflict between visual and somatosensory information and visual-vestibular interaction. Deterioration in postural control was significantly associated with history of falls.

Postural balance in type 2 diabetics with vertigo, dizziness and/or unsteadiness.

PURPOSE: To evaluate the postural balance of type 2 diabetics with vertigo, dizziness, and/or unsteadiness. METHODS: limit of stability, pressure center displacement area, and sway velocity of 20 patients with type 2 diabetes were compared with 22 controls using the Balance Rehabilitation Unit (BRUTM, Medicaa) posturography. RESULTS: Compared to the control group, patients with type 2 diabetes showed a significantly lower limit of stability and a significantly higher-pressure center displacement area on a firm surface with eyes open, eyes closed, and horizontal vestibular-visual interaction; and higher sway velocity on a firm surface with eyes open and with eyes closed. CONCLUSION: type 2 diabetics with vertigo, dizziness, and/or imbalance compromised postural balance related to visual stimuli and vestibular-visual interaction and moderate impairment in the quality of life.

Neurotology: definitions and evidence-based therapies - Results of the I Brazilian Forum of Neurotology.

INTRODUCTION: Neurotology is a rapidly expanding field of knowledge. The study of the vestibular system has advanced so much that even basic definitions, such as the meaning of vestibular symptoms, have only recently been standardized. OBJECTIVE: To present a review of the main subjects of neurotology, including concepts, diagnosis and treatment of Neurotology, defining current scientific evidence to facilitate decision-making and to point out the most evidence-lacking areas to stimulate further new research. METHODS: This text is the result of the I Brazilian Forum of Neurotology, which brought together the foremost Brazilian researchers in this area for a literature review. In all, there will be three review papers to be published. This first review will address definitions and therapies, the second one will address diagnostic tools, and the third will define the main diseases diagnoses. Each author performed a bibliographic search in the LILACS, SciELO, PubMed and MEDLINE databases on a given subject. The text was then submitted to the other Forum participants for a period of 30 days for analysis. A special chapter, on the definition of vestibular symptoms, was translated by an official translation service, and equally submitted to the other stages of the process. There was then a in-person meeting in which all the texts were orally presented, and there was a discussion among the participants to define a consensual text for each chapter. The consensual texts were then submitted to a final review by four professors of neurotology disciplines from three Brazilian universities and finally concluded. Based on the full text, available on the website of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery, this summary version was written as a review article. RESULT: The text presents the official translation into Portuguese of the definition of vestibular symptoms proposed by the Bárány Society and brings together the main scientific evidence for each of the main existing therapies for neurotological diseases. CONCLUSION: This text rationally grouped the main topics of knowledge regarding the definitions and therapies of Neurotology, allowing the reader a broad view of the approach of neurotological patients based on scientific evidence and national experience, which should assist them in clinical decision-making, and show the most evidence-lacking topics to stimulate further study.

Benign paroxysmal positional vertigo: concomitant involvement of different semicircular canals.

OBJECTIVES: We evaluated the simultaneous ipsilateral or contralateral involvement of the posterior and lateral, anterior and lateral, or posterior and anterior semicircular canals in patients with benign paroxysmal positional vertigo (BPPV). METHODS: The files of 2345 patients with BPPV were analyzed. RESULTS: Single-canal BPPV occurred in 2310 cases (98.5%)--unilaterally in 2058 (89.1%) and bilaterally in 252 (10.9%). Multiple-canal BPPV occurred in 35 cases (1.5%). Of these 35 cases, there was simultaneous involvement of the posterior and lateral canals on the same side (23) or on opposite sides (9) in 32 cases (91.4%). Simultaneous involvement of the anterior canal on one side and the posterior canal on the opposite side occurred in 2 cases (5.7%), and that of the anterior canal on one side and the lateral canal on the opposite side occurred in 1 case (2.9%). All cases represented canalithiasis. CONCLUSIONS: Multiple-canal BPPV was rare, and usually involved canals on the same side; simultaneous involvement of the posterior and lateral canals was much more common than involvement of the anterior and posterior canals or the anterior and lateral canals. Trauma increased the risk for multiple-canal BPPV, but not the risk for bilateral single-canal BPPV. Cupulolithiasis was not a factor in multiple-canal BPPV.

Body balance at static posturography in vestibular migraine.

INTRODUCTION: Migraine is one of the most frequent and incapacitating headaches, with a high degree of impairment in quality of life. Its association with vestibular symptoms is common, including imbalance and postural instability. OBJECTIVE: To evaluate the body balance of patients with vestibular migraine through a static posturography test. METHODS: An experimental group of 31 patients with a medical diagnosis of vestibular migraine in the intercritical period of the disease, and a control group of 31 healthy individuals, matched for age and gender, were submitted to the eight sensory conditions of the Tetrax Interactive Balance System. The parameters analyzed were: stability index, which measures the amount of sway, global stability and ability to compensate postural modifications; weight distribution index, which compares deviations in weight distribution; synchronization index, which measures the symmetry in the weight distribution; postural sway frequency, which indicates the frequency range with more sway; and fall risk index, which expresses the probability of falls. RESULTS: The stability index was higher in the experimental group in all eight sensory conditions, with a significant difference between the groups in six of them. The weight distribution index was higher in the experimental group in all conditions, with a significant difference in three of them. The number of cases with preferential sway in F2-F4 was significantly higher in the experimental group in three conditions, and in F5-F6 in two, while the fall risk was significantly higher in the experimental group than in the control group. CONCLUSION: Patients with vestibular migraine showed compromised body balance at the static posturography test.

Digital craniocorpography and peripheral vestibular diseases.

Peripheral vestibular diseases (PVDs) often produce many symptoms but few or no measurable signs. Tests that capture and measure signs permit the comparison between normal and vertiginous populations. The aim of our research was to find movement patterns that could identify PVD patients, using a motion analysis laboratory. The results from 21 asymptomatic volunteers who underwent the Unterberger-Fukuda stepping test were compared to those of 38 PVD patients. We established diagnosis after a complete otoneurological workup prior to the stepping test. The VICON 370 (Oxford Metrics Ltd, Oxford, UK) was used for digital capture and analysis of the stepping tests. Lateral sway, linear and total displacement, shoulder height oscillation, and torticollis angle were the same for individuals in both groups, but stepping time, body spin, and angular deviation were statistically greater in those in the patient group and might help in the diagnosis of PVDs.

Auditory processing assessment in older people with no report of hearing disability.

UNLABELLED: In the elderly, the results of central auditory pathways behavioral assessments are considered to be difficult to read because of the possible interference of peripheral auditory pathway involvement. AIM: Assess the efficacy of the central auditory function in elderly patients who do not complain of hearing. MATERIALS AND METHODS: Case study involving 40 individuals within the age range of 60 to 75 years. The patients underwent auditory processing evaluation based on anamnesis, otorhinolaryngological exam, threshold tonal audiometry, speech recognition threshold, speech recognition index, immittance measures, stapes reflex study, synthetic phrases identification test with ipsilateral competitive message, frequency pattern test and alternate twin-syllable test through dichotic task; age range and hearing loss influenced results from the phrases identification with ipsilateral competitive message. Percentages of right answers below normal standards were seen in the three tests that assessed the central auditory functions. CONCLUSION: Elderly individuals who did not complain of hearing presented relevant prevalence of signs of central auditory function inefficiencies.

Controle postural na doença de Menière / Postural control in Menière's disease

RESUMO Objetivo Avaliar o controle postural na doença de Menière. Métodos 34 pacientes com doença de Menière definida (grupo experimental) e 34 indivíduos hígidos (grupo controle), homogêneos quanto à idade e ao gênero, foram submetidos à posturografia do Tetrax Interactive Balance System (Tetrax IBS TM) em oito condições sensoriais. Índice de estabilidade, índice de distribuição de peso, índice de sincronização da oscilação postural direita/esquerda e dedos/calcanhar, frequência de oscilação postural e índice de risco de queda foram analisados. Resultados O índice de estabilidade foi maior no grupo experimental, com diferença significativa entre os grupos, em todas as condições sensoriais testadas. O risco de queda foi maior no grupo experimental do que no grupo controle. A oscilação postural foi maior no grupo experimental em todas as faixas de frequência, com diferença significativa em algumas delas. Não houve diferença significativa entre os grupos nos índices de distribuição de peso e de sincronização, nas oito condições sensoriais avaliadas. Conclusão Pacientes com doença de Menière apresentam comprometimento do controle postural, caracterizado por alterações do índice de estabilidade, em frequências de oscilação postural e no índice de risco de queda.

ABSTRACT Purpose To evaluate postural control in Menière's disease. Methods 34 patients with Menière's disease (experimental group) and 34 healthy individuals (control group) were submitted to Tetrax Interactive Balance System posturography under eight sensory conditions. Stability, weight distribution, synchronization, risk of falling and postural oscillation frequency were analyzed. Results Stability index was higher in the experimental group with significant difference between the groups in all sensory conditions. Risk of falling was higher in the experimental group than in the control. Postural oscillation was higher in the experimental group in all frequency ranges, with significant difference in some of them. There was no significant difference between the groups in the weight distribution and synchronization indexes. Conclusion In this study, Menière's disease patients presented impaired postural control, characterized by postural instability and oscillation and risk of falling.

Subjective Visual Vertical and Vestibular Evoked Myogenic Potential in Meniere's disease,

Abstract Objective To evaluate otolith function by comparing the findings of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential tests in patients in the inter-crisis period of unilateral definite Meniere's disease. Methods The sample consisted of an experimental group (n = 22; 10 men and 12 women, mean age 47.32 ± 12.82 years) with definite unilateral Meniere's disease and a control group (n = 14; 5 men and 9 women, with a mean age of 41.64 ± 13.45 years). They all underwent vestibular evaluation by means of Subjective Visual Vertical with the bucket method and, cervical and ocular Vestibular Evoked Myogenic Potential tests. The data were collected and subjected to statistical analysis. Results The results of the comparison of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential, the ocular Vestibular Evoked Myogenic Potential and, the association of cervical Vestibular Evoked Myogenic Potential with the ocular Vestibular Evoked Myogenic Potential showed no significant difference, indicating concordance among the tests. Conclusion The identified abnormalities and the concordance between the combined proportion of the Subjective Visual Vertical, the cervical Vestibular Evoked Myogenic Potential and the ocular Vestibular Evoked Myogenic Potential findings indicate that the association of these three tests contributes to the identification of sustained and transient otolith dysfunction in the inter-crisis of unilateral definite Meniere's disease. Level of evidence 2.

Epley's maneuver in the same session in benign positional paroxysmal vertigo.

AIM: To assess whether more than one Epley's maneuver in the same session, compared to a single one, decreases the number of sessions necessary to suppress positional nystagmus. METHODS: Epleys maneuver was done in 123 patients with BPPV due to unilateral posterior semicircular canal canalolithiasis. The number of sessions for positional nystagmus suppression was compared in two groups of patients. Group I consisted of 75 patients submitted to a single Epley's maneuver on weekly sessions and group II consisted of 48 patients that were submitted to four Epley's maneuvers during the first session. RESULTS: Group II showed greater nystagmus latency and duration than group I (p<0.05). The number of sessions and standard deviation showed by group I was greater than in group II (p=0.008). We observed a significant association between number of sessions and group (p=0.039) studied. Group II had 21.4% more nystagmus-free patients following only one session (CI95% [7.7% - 35.1%]). CONCLUSION: Repeated Epley's maneuvers in less sessions rendered more positional nystagmus-free patients when compared to those submitted to more sessions of single maneuvers.

Epley's maneuver in benign paroxysmal positional vertigo associated with Meniere's disease.

UNLABELLED: The effects of Epley's maneuver in benign paroxysmal positional vertigo (BPPV) associated with Menière's disease are controversial. AIMS: To evaluate the progression of positional vertigo and nystagmus after one or more of Epley's maneuvers in BPPV associated with Menière's disease, and the recurrence of BPPV. METHOD: a retrospective study of 62 patients with BPPV associated with Menière's disease, that underwent Epley's maneuver, and that were monitored during 12 months after elimination of positional nystagmus. RESULTS: One Epley's maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after elimination of nystagmus, positional vertigo was suppressed in 71.0% of the patients, improved in 27.4% and remained unaltered in 1.6%. Four weeks after elimination of positional nystagmus, all patients were asymptomatic. Recurrence of BPPV was seen in 19.4% of the cases, with elimination of the positional vertigo and nystagmus by means of the specific maneuver for the involved canal. CONCLUSION: In BPPV associated with Menière's disease, vertigo and positioning nystagmus were eliminated with one, two or three Epley maneuvers. BPPV recurrence was resolved by using a specific maneuver for the affected canal.

Optimizing the pharmacological component of integrated balance therapy.

UNLABELLED: Drug treatment is an important option for the treatment of peripheral vestibular diseases. AIM: To identify the drug component associated with optimal integrated balance therapy (IBT) for Ménières disease or other peripheral vestibular disorders. MATERIALS AND METHODS: Analysis of a series of patients with Ménières disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days. RESULTS: In Ménières disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-Ménières disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated. CONCLUSIONS: Drug therapies were more effective than no medication in the IBT for patients with Ménières disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with Ménières disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.

Subjective visual vertical after treatment of benign paroxysmal positional vertigo.

INTRODUCTION: Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. OBJECTIVE: To compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo. METHODS: We evaluated 20 patients. The estimated position where a fluorescent line within a bucket reached the vertical position was measured before and immediately after the particle repositioning maneuver. Data were tabulated and statistically analyzed. RESULTS: Before repositioning maneuver, 9 patients (45.0%) had absolute values of the subjective visual vertical above the reference standard and 2 (10.0%) after the maneuver; the mean of the absolute values of the vertical deviation was significantly lower after the intervention (p<0.001). CONCLUSION: There is a reduction of the deviations of the subjective visual vertical, evaluated by the bucket test, immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo.

Postural Control in Relapsing-Remitting Multiple Sclerosis

Abstract Introduction Postural instability is considered one of the most disabling symptoms of relapsing-remitting multiple sclerosis (RRMS). Objective To evaluate postural control in patients with RRMS. Method A total of 79 individuals between 18 and 65 years old, of both genders, were distributed into an experimental group composed of patients with RRMS (n = 51) and in a control group composed by healthy individuals (n = 28). The evaluation consisted of anamnesis, Dizziness Handicap Inventory (DHI), visual vertigo analog scale (WAS), and static posturography (Tetrax IBS). Results Patients with RRMS presented mild degree in the DHI and in the VVAS; in Tetrax IBS, they presented higher or lower values of the indices of general stability, weight distribution, synchronization of postural oscillation, fall risk, and frequency bands of postural oscillation in two, five or all eight sensory conditions, in relation to the control group. Vestibular, visual and/or somatosensory dysfunction of peripheral type (51.0%) prevailed over the central type. The RRMS group, with an expanded scale of disability status > 3 points, presented a higher fall risk than with a score ≤ 3 points (p = 0.003). There was a positive correlation of the Fall Risk Index with the total DHI Score (s = 0.380; p = 0.006) and with the VVAS score (s = 0.348; p = 0.012). Conclusion Patients with RRMS may present with inability to maintain postural control due to general instability, desynchronization and increased postural oscillation at frequencies that suggest deficiencies in the vestibular, visual, and somatosensory systems; as well as fall risk related to the state and intensity of functional disability and self-perception of the influence of dizziness on quality of life.

Relationship between head-only rotation and caloric test results in vestibular disorders.

Our purpose was to determine the possible existence of a relationship between abnormal findings from head-only rotation and those from caloric tests applied in patients with peripheral vestibular disorders. We retrospectively studied the head-only rotation and caloric test results of 75 patients experiencing dizziness and peripheral vestibular dysfunction. We assessed the relationship between abnormal test results using the Cramér coefficient. Abnormal findings in the head-only rotation test occurred in 87.5% of patients with vestibular hypoexcitability and in 94.3% of those with hyperexcitability or directional preponderance of post-caloric nystagmus. Statistical analysis of the association between the values found for the parameters of head-only rotation and caloric test results revealed a Cramér coefficient that was less than 0.70. We found no relationship between abnormal findings from head-only rotation and caloric tests applied to individuals with peripheral vestibular disorders.

Oculomotor evaluation in patients with peripheral vestibular dysfunction.

AIM: To assess whether or not the parameters of fixed and randomized saccadic movements, of pendular tracking and of optokinetic nystagmus in the digital vectonystagmography may show abnormalities in patients with possible diagnosis of peripheral vestibular dysfunction. METHOD: 60 patients with dizziness of peripheral vestibular origin, from 12 to 82 years of age, males and females, were evaluated in the Universidade Federal de São Paulo. Ocular movement parameter findings were compared to a normal pattern. RESULTS: Fixed saccadic movements were altered in 100% of the cases as to latency, and in 35.0% of the cases as to speed; the randomized saccadic movements were altered in 100% of the cases as to latency, in 78.3% as to precision, and in 1.7% as to speed; the pendular tracking showed a gain alteration in the frequencies of 0.1 Hz in 15% of the cases, 0.2 Hz in 21.7%, and 0.4 Hz in 13.3%; the optokinetic nystagmus showed an alteration of the angular speed in the slow component in 1.7% of the cases, and in gain in 5.0%. CONCLUSION: Fixed saccadic movement latency and speed, randomized saccadic movement latency, precision and speed, pendular tracking gain, slow component angular speed, and optokinetic nystagmus gain in the digital vectonystagmography may show abnormalities in patients with possible diagnosis of peripheral vestibular dysfunction.

Functional balance associated factors in the elderly with chronic vestibular disorder.

UNLABELLED: Daily activities can be challenging for the elderly. AIM: To study the association between functional balance, evaluated by the Berg Balance Scale (BBS), sociodemographics, clinical and mobilility (Timed up and go test-TUGT, Dynamic Gait Index-DGI) variables in the elderly with chronic vestibular disorder. MATERIALS AND METHODS: A series study with one hundred and twenty elderly with chronic vestibular disorder. We performed the Mann-Whitney test, the Kruskal-Wallis test followed by Dunn test and the Spearman Coefficient ([FORMULA: SEE TEXT]). RESULTS: Statistically significant associations and correlations were observed between total BBS score and age ([FORMULA: SEE TEXT]=-0.354; p<0.001), age group (p<0.001), number off illnesses (p=0.030), number of illnesses ([FORMULA: SEE TEXT]=-0.287; p=0.001), number of medications (p=0.014), number of medications ([FORMULA: SEE TEXT]=-0.274; p=0.002), recurrent falls (p=0.010), tendency to fall (p=0.002), topographic diagnosis of central vestibular disorder (p<0.001) and periodicity of dizziness (p=0.039), TUGT ([FORMULA: SEE TEXT]=-0.709; p<0.001) and DGI ([FORMULA: SEE TEXT]=-0.748; p<0.001). CONCLUSIONS: Functional balance in the elderly with chronic vestibular disorders evaluated by the BBS is worse when associated with aging, with a more advanced age group (80 years or more), increasing number of illnesses, presence of five or more illnesses, use of multiple medications, recurrent falls, tendency to fall, central vestibular syndromes, daily dizziness, mobility and gait impairments.