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