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.
Acute vestibular neuritis is the disorder characterized by acute, spontaneous vertigo with the unilateral vestibular loss. Reactivation of herpes simplex virus is considered as its cause. Its management consists of symptomatic therapy in the acute phase and following rehabilitation exercise to improve central compensation. The differential diagnosis should include central vestibular disorders mimicking peripheral vertigo. Ramsay-Hunt syndrome, which defined as a herpes zoster oticus with facial paresis, is also a disorder frequently accompanied with vestibular deficit. Combination therapy of acyclovir and corticosteroid is recommended for the treatment. In this review, diagnosis and management of the two disorders are described.
Background and Objectives: The etiology of vestibular neuritis is unknown. Many investigators have suggested that this condition spares the inferior vestibular nerve system. However, others have reported that the lesion sometimes affects the inferior vestibular nerve system based on vestibular evoked myogenic potential. The function of the inferior vestibular nerve was studied in acute vestibular neuritis by monitoring medial olivocochlear bundle (MOCB) function. Under normal conditions, contralateral acoustic stimulation has inhibitory effects on ipsilateral otoacoustic emissions through the MOCB. Materials and Methods: Twenty patients that presented with dizziness and spontaneous nystagmus, and were confirmed to have acute vestibular neuritis by rotatory chair and caloric testing were enrolled in this study. We evaluated the evoked otoacoustic emissions with and without contralateral acoustic stimulation in both ears in all patients. The percent loss of normal inhibitory action on otoacoustic emissions was determined in the normal and affected ears. Results: All patients showed inhibitory effects in response to contralateral acoustic stimulation on evoked otoacoustic emissions in normal ears. Fifteen patients (75%) had an absence of contralateral suppression of otoacoustic emissions on the affected side. Conclusion: The findings of this study suggest the presence of dysfunction of the MOCB in patients with acute vestibular neuritis.
Background and objective: By assessing unilateral utricular function at the acute unilateral vestinuloneuritis (Acute UVN), we sought to determine the ability of the subjective visual vertical (SVV) during eccentric rotation (dynamic SVV) in localizing the site of the lesion in unilateral vestibular neuritis (UVN).
Methods: The static SVV and dynamic SVV of fifteen patients diagnosed with acute UVN were enrolled within 10 days of onset (average 7 days). First, the static SVV was measured in a dark booth without rotation. The dynamic SVV was measured during rotation with an eccentric displacement of the head to 3.5 cm from the vertical rotation axis during a constant velocity of 300°/s.
Results: In the acute stage of UVN, the static SVV showed an increase in deviation to the side of the lesion compared to those of normal subjects. Also, we found 73% of abnormal findings in Acute UVN patients by assessing static conventional SVV. The dynamic SVV had a statistically significant increase in deviation to the side of the lesion compared to those of normal subjects and 93% patients showed beyond normal range.
Conclusions: The dynamic SVV would be an effective method in the diagnosis and localization of acute unilateral vestibularneuritis,
Key words: Acute vestibular neuritis, Subjective visual vertical, Eccentric rotation
The acute vestibular neuritis is rarely seen in children and it is hard to find the related reports. In this paper, we report three cases of acute vestibular neuritis less than 15 years old that we experienced during last 10 years. The three cases are 14 and 11-year old boys and a 12-year-old-girl. They complained vertigo without hearing loss. Only one of three cases had previous common cold history and they showed all negative reactions in virus blood tests. After medical treatment and early rehabilitation, vertigo was completely controlled within 3 weeks and there was no recurrent symptoms so far. This recovery in children seems to be faster and more complete than in adults.