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Effect of early high-dose steroid treatment in patients with acute vestibular neuritis: a retrospective case-control study
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Jung-Yup Lee, Hyun-Seok Kang, Sang-Hyun Kim, Min-Beom Kim
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Res Vestib Sci. 2024;23(2):53-60. Published online June 14, 2024
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DOI: https://doi.org/10.21790/rvs.2024.007
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 Abstract
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- Objectives
This study is performed to evaluate the effect of early steroid treatment within 24 hours of onset in acute vestibular neuritis (AVN).
Methods
We performed a retrospective case-control study with 46 patients with AVN. Video head impulse test paradigm (HIMP) and suppression HIMP were performed, and dizziness handicap index (DHI) was determined at initial; all tests were repeated at 1 month. Patients were divided into two groups depending on whether they were treated with steroids (group S, n=21) or not (group n-S, n=25).
Results
There was no significant difference in age, sex, and side between the two groups. In HIMP, group S showed a significantly lower occurrence of overt corrective saccade (CS) (p=0.034) and lower peak velocity of overt CS (p=0.020) than group n-S at 1 month. In addition, the DHI score at 1 month was significantly lower in group S than in group n-S (p=0.040). In correlation analysis between subjective symptom and objective parameters, the DHI score showed a significant correlation with the occurrence of overt CS (p=0.028) and PR score (p=0.006) at 1 month.
Conclusions
Early steroid treatment in AVN would be helpful for relieving symptoms and the improvement of vestibular ocular reflex function in the recovery phase.
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A Case of Pontine Infarction with Facial Palsy and Vertigo Confused with Ramsay Hunt Syndrome
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Jae Seon Park, Sang Hyun Kim, Jung-Yup Lee, Min-Beom Kim
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Res Vestib Sci. 2022;21(2):57-62. Published online June 15, 2022
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DOI: https://doi.org/10.21790/rvs.2022.21.2.57
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Abstract
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- Facial palsy can be caused by central and peripheral causes, and it can also be caused by brain tumors or infarction. A 59-year-old male, who lost his right hearing 13 years ago due to Ramsay Hunt syndrome, visited our hospital with facial palsy and dizziness. Initial brain diffusion-weighted magnetic resonance imaging (MRI) showed no abnormal findings, and recurrent Ramsay Hunt syndrome or a neoplastic lesion in the internal auditory canal was suspected. After hospitalization, the patient was administered high-dose steroids, and the videonystagmography showed direction-changing gaze-induced nystagmus, so a brain MRI reexamination was scheduled. While waiting for MRI, the patient complained of neurological symptoms such as diplopia, and right lower pontine infarction was diagnosed on MRI. The patient was transferred to the neurologic department and was discharged on the 10th day after conservative treatment. During the 1-year follow-up, pontine infarction did not recur, and neurological symptoms such as facial palsy gradually improved.
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Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo
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Jung-Yup Lee, In-Buhm Lee, Min-Beom Kim
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Res Vestib Sci. 2021;20(3):93-100. Published online September 15, 2021
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DOI: https://doi.org/10.21790/rvs.2021.20.3.93
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Abstract
PDF
- Objectives
This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB).
Methods
A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS＞0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results.
Results
There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (p＜0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation.
Conclusions
We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.
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Citations
Citations to this article as recorded by  - Immediate Improvement in Subjective Visual Vertical and Disequilibrium Predicts Resolution of Benign Paroxysmal Positional Vertigo Following Single Canalith Repositioning Maneuver
Christine C. Little, Zachary G. Schwam, Marc Campo, James Gurley, Bryan Hujsak, Maura K. Cosetti, Jennifer Kelly
Otology & Neurotology Open.2022; 2(3): e014. CrossRef - Gait and Postural Control Characteristics among Individuals with Benign Paroxysmal Positional Vertigo: A Scoping Review
Haziqah Nasruddin, Maria Justine, Haidzir Manaf
Malaysian Journal of Medicine and Health Sciences.2022; 18(s15): 377. CrossRef
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