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Toxic vestibulopathy F098

Document
Last amended 
16 November 2020
Current RMA Instruments
Reasonable Hypothesis SOP
88 of 2020
Balance of Probabilities SOP
89 of 2020
SOP bulletin information on new SOP

SOP Bulletin 217

ICD Coding
  • ICD-9-CM Codes: 386.9
  • ICD-10-AM Codes: H81.8
Brief description

Toxic vestibulopathy is damage to the vestibular organs of the inner ear or the vestibular nerve as a result of exposure to a chemical agent, and resulting in clinical manifestations (symptoms and signs). Symptoms may include nausea, vomiting, vertigo, dizziness, disequilibrium, nystagmus (eye jerking), and oscillopsia (blurred vision with head movement). 

Confirming the diagnosis

The diagnosis is made clinically based on the history and findings on examination.

The relevant medical specialist is an Ear, Nose and Throat (ENT) surgeon. 

Additional diagnoses covered by these SOPs
  • Nil
Conditions not covered by these SOPs   
  • Acoustic neuroma*
  • Benign paroxysmal positional vertigo*
  • Labyrinthitis#
  • Meniere's disease*
  • Migraine*
  • Vertigo of central origin#
  • Vertigo as a symptom
  • Vestibular neuritis#

* another SOP applies

# non-SOP condition 

Clinical onset

The assessment of clinical onset begins with the confirmed diagnosis, then goes back in time to the first onset of reliable clinical symptoms and signs following the chemical exposure. 

Clinical worsening

The usual course for toxic vestibulopathy is to improve or persist but not worsen unless there is ongoing exposure to the chemcial agent. 

Comments

As a result of toxic vestibulopathy there may be sensorineural hearing loss and tinnitus, both of which may resolve if the vestibulopathy reverses over time. If there is persistent hearing loss and tinnitus these should be separately determined using the relevant RMA SOPs.