Research in Vestibular Science

Original Article

Cardiovascular Risk Factors in Total or Divisional Vestibular Neuritis: Seunghee Na, Eek-Sung Lee, Ki-Bum Sung, Tae-Kyeong Lee; Res Vestib Sci. 2017;16(4):135-141. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.135

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Abstract PDF: Objectives
In vestibular neuritis (VN), the lesion preferentially affects the superior vestibular nerve because of the anatomic arrangement. It is well known that VN patients have a higher score of metabolic syndrome or a higher incidence of vertebral artery hypoplasia than controls. However, it is unclear whether the frequency of cardiovascular risk factors can affect the selective involvement of the branch of the vestibular nerve. Thus, we investigated the influence of cardiovascular risk factors on the development of total- or divisional VN. Methods: 61 patients with VN were enrolled. Video head impulse tests and caloric tests were performed to determine which vestibular divisionswere affected. The patients were divided into divisional-VN (superior or inferior) and total-VN groups. Statistical analysis of the frequency of cardiovascular risk factors was performed only in superior and total VN groups because the number of inferior VN patients was too small to be statistically analyzed. Results: Nineteen (31.1%) patients were classified as the total-VN group. In the divisional-VN group (42 patients, 65.6%), 40 were superior VN. The frequency of cardiovascular risk factors are not significantly different in superior VN and total-VN groups (All patients 50/61 [82.0%], superior-VN 36/40 [90.0%], total-VN 13/19 [68.4%]). The frequency of having more than one cardiovascular risk factor was slightly higher in the superior VN group, (13 [68.4%] vs. 36 [90.0%], p=0.062) but did not show any significant difference. Conclusions: The number of cardiovascular risk factors did not differ in superior VN patients compared to total VN patients.

Case Reports

A Case of Patient with Meniere’s Disease Who Presented Periodic Alternating Nystagmus: Jin Woo Park, Ja Won Gu, Mee Hyun Song, Dae Bo Shim; Res Vestib Sci. 2016;15(3):80-83. Published online September 15, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.3.80

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Abstract PDF: Periodic alternating nystagmus (PAN) is a spontaneous horizontal jerky nystagmus that reverses its direction periodically with a quiescent interval. PAN has been reported in acquired and congenital forms. The main lesion site of the acquired form of PAN has been attributed to the caudal brainstem or cerebellum. Herein we report a 63-year-old male patient with Meniere’s disease, who presented PAN during a vertigo attack. The patient demonstrated no abnormality on neurologic evaluation and brain imaging, which is different feature compared to the central or congenital form of PAN. It should be kept in mind that peripheral vestibular disorders such as Meniere’s disease can produce PAN.

Vestibular Paroxysmia in a 7-Year-Old Child: Seok Min Hong, Sung Ho Choi, Il Seok Park, Yong Bok Kim; Res Vestib Sci. 2014;13(1):19-23.

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Abstract: Neurovascular cross-compression of the eighth cranial nerve is characterized by brief attacks of vertigo, unilateral audiologic symptoms such as tinnitus, ear fullness and hearing disturbance and relatively rare disease, in particular, in children. We report a 7-year-old female patient who presented with recurrent spontaneous vertigo, lasting 15 seconds and occuring up to 40 times per day and often associated with physical activity. Her symptoms were developed by hyperventilation. Associated aural symptoms are not founded. Magnetic resonance image showed the eighth cranial nerve compression caused by the vascular loop. She was treated with oxcarbazepine and showed improving symptoms. Therefore we report our clinical experience with a brief review of literature.

Original Article

Contralateral Suppression of Transient Evoked Otoacoustic Emission in Vestibular Neuritis: Hoon Young Woo, Jung Hyeob Sohn, Young Sam Yoo, Jeong Hwan Choi; Res Vestib Sci. 2011;10(1):7-11.

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Abstract PDF: 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.

Case Reports

Herpes Zoster Oticus Involving Superior And Inferior Vestibular Nerve Without Facial Nerve Palsy: Hung Soo Kang, Sea Yuong Jeon, Dong Gu Hur, Seong Ki Ahn; J Korean Bal Soc. 2008;7(1):68-72.

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Abstract PDF: Herpes zoster oticus (HZO) is characterized by auricular vesicles, facial palsy and vestibulocochlear dysfunction. The 8th cranial nerve can be most frequently involved. Rarely, it may be associated with the involvement of 5th, 6th, 9th, 11th or 12th cranial nerve. However, only few cases of HZO involving vestibular nerve without facial nerve palsy have been previously reported. We experienced an unusual case of 38-year-old woman who presented with auricular vesicles, otalgia, and vertigo of whilrling nature but not with facial palsy. Vestibular evoked myogenic potential (VEMP) and caloric tests that were performed to determine which division of vestibular nerve was involved demonstrated that decreased responses in this case. We report a case of HZO involving superior and inferior vestibular nerve without facial palsy that was confirmed by VEMP and caloric tests with a review of literature.

A Case of Herpes Zoster Oticus Involving Vestibular Nerve without Facial Nerve Palsy: Sung Hyun Boo, Kwon Hyo Bok, Nam Gyu Ryu, Won Ho Chung; J Korean Bal Soc. 2006;5(2):311-316.

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Abstract PDF: Herpes zoster oticus (Ramsay Hunt syndrome) is characterized by facial nerve paralysis associated with vesticular eruptions and cochleovestibular symptoms. Many evidences have supported that it is caused by the reactivation of latent varicella-zoster virus in the geniculate ganglion. Recently we experienced a case 49-year-old man presented severe vertigo and a vesicular eruptions of auricle and external ear canal. It is an unusual variant of herpes zoster oticus that involves only vestibular nerve without facial nerve palsy and hearing loss. We believe this case results from reactivation of latent varicella zoster virus in the vestibular ganglion and report with a review of literatures. Key Words: Herpes zoster oticus, Vestibular nerve, Vertigo, Dizziness

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