Visual Vestibular Mismatch

A poorly understood presentation of balance system disease

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Appendix 1

Visual vestibular mismatch questionnaire

Are you made unwell by

  • going on an escalator
  • watching traffic at an intersection
  • being in a supermarket
  • walking in a shopping mall
  • seeing checkerboard floor patterns

“VVM POSITIVE” = 3, 4, OR 5 POSITIVE ANSWERS
“VVM NEGATIVE” = 0, 1 OR 2 POSITIVE ANSWERS

It must be remembered that there are some limitations to the questionnaire:

  • A patient may not have the English skills to answer the questions (or to give an accurate history)
  • A questionnaire might be leading or suggestive
  • A patient might not have been exposed to the offending stimuli
  • A patient might be “overly cooperative” and supply positive answers without thinking