Case Report: Bilateral vestibulopathy associated with leptomeningeal metastasis

Bilateral vestibulopathy (BVP) presents with oscillopsia, unsteadiness, and imbalance. Leptomeningeal metastasis (LM) is a rare and underrecognized cause of BVP, with direct infiltration of the vestibulocochlear nerves representing a potential mechanism of bilateral vestibular dysfunction. We report a case of LM-related BVP documented by quantitative video head impulse test (vHIT) of all six semicircular canals....

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No actionable change to routine audiology practice; however, clinicians evaluating bilateral vestibulopathy of unknown cause in oncology patients should consider leptomeningeal metastasis in the differential diagnosis.

This case highlights a rare but serious oncological etiology of bilateral vestibulopathy that audiologists and neurologists may miss, underscoring the need for thorough medical history review in unexplained bilateral vestibular presentations.

1. 01Bilateral vestibulopathy associated with leptomeningeal metastasis is rare and underrecognized.
2. 02Patient presented with oscillopsia (visual blurring with head movement), unsteadiness, and imbalance.
3. 03Cancer cells spreading to brain/spinal cord membranes can damage both vestibular systems simultaneously.
4. 04Case reports provide low-level evidence; findings cannot be generalized.
5. 05Published in Frontiers in Oncology (DOI: 10.3389/fonc.2026.1981680).

PMID

42978578

DOI

10.3389/fonc.2026.1981680.

Journal

Frontiers in Oncology

Publication type

case_report

Evidence level

4

Sample size

1

Population

Individual patient with bilateral vestibulopathy secondary to leptomeningeal metastasis

Intervention

Diagnostic evaluation of bilateral vestibulopathy in the context of leptomeningeal metastasis