Bilateral vestibulopathy can also be due to infection (meningitis, about 10%), Meniere's disease, sarcoidosis, bilateral ear surgery such as for certain forms of acoustic neuroma or bilateral vestibular neuritis, congenital disorders with deafness such as the Mondini malformation, and very rarely, from disorders of the immune system. One rare familial form is associated with migraine. Some causes accompanied by hearing loss may be due to auditory neuropathy. Advanced age is another risk factor as normally vestibular ganglion cell counts decrease with age so that by the age of 80 years, about 50% of vestibular neurons remain. Recently, the statistically rare co-occurance of cerebellar ataxia, neuropathy and vestibular areflexia (bilateral loss) has been assigned the acronym "CANVAS SYNDROME". In about a third of all cases no cause can be identified for bilateral vestibular loss (Syms and House, 1997).
There is also accumulating evidence that free radical generation plays an important role in ototoxicity. This information is the basis of experimental treatments to prevent ototoxicity.