Background
and Objectives: Etiology of acute unilateral peripheral vestibulopathy
(AUPV) includes virus, ischemia, and autoimmune. As anatomical distribution is
similar between vasculature and innervation, AUPV with vascular risk factors
could be ischemic origin. We investigated the pattern of audiovestibular
dysfunction to explore the influence of risk factors on AUPV. Materials and
Methods
We collected records of 162 AUPV patients from 2011 to 2013 who
were admitted within 7 days from vertigo onset and diagnosed as AUPV by caloric
test and neuro-otologic examination. Vascular risk factors are stroke history,
hypertension, diabetes, body mass index >25, age >60, and vertebrobasilar
stenosis. Bedside examination includes spontaneous nystagmus grade, head
impulse test, head shaking test. Results of rotatory chair test (n=125), caloric test
(n=162), cervical (n=33) and ocular (n=23) vestibular evoked myogenic potential
(VEMP), subjective visual vertical (SVV) (n=91), and pure tone audiometry (PTA)
(n=62) are collected. Results: Abnormalities of PTA are found more in patients
with vascular risk factor than without any risk factor. Specifically, hypertension
(p=0.008) and old age (p=0.025) are associated with PTA abnormality (p=0.006).
Tilt angle of vertical is larger in risk factor group (p=0.019). The number of
vascular risk factor correlates with abnormalities of PTA (p=0.025) and tilt angle
of SVV. Results of bedside examination, rotatory chair test, caloric test, cervical
and ocular VEMP are not associated with vascular risk factors. Conclusion: AUPV
patients with vascular risk factors have more extensive involvement of
audiovestibular function. Ischemic etiology may contribute to pathogenesis of
extensive AUPV.