Visuospatial dysfunction in patients with the right vestibular neuronitis

Jeon, Seung-Ho; Oh, Sun-Young; Kim, Ko-Woon; Shin, Hyun-June; Shin, Byoung-soo; Seo, Man-Wook

Research in Vestibular Science > Accepted Articles

Seung-Ho Jeon¹, Sun-Young Oh¹, Ko-Woon Kim¹, Hyun-June Shin¹, Byoung-soo Shin¹, Man-Wook Seo¹

¹Jeonbuk National University Hospital, Jeonju, Korea
²Biomedical Research Institute, Chonbuk National University, Jeonju, Korea

Correspondence

Sun-Young Oh ,Tel: +82-63-250-1896, Fax: +82-63-251-9363, Email: ohsun@jbnu.ac.kr

Received: August 3, 2018; Accepted: October 1, 2018. Published online: October 1, 2018.

ABSTRACT

Acute vestibular neuritis is characterized by acute/subacute vertigo with spontaneous nystagmus and unilateral loss of semicircular canal function. Vestibular system in human is represented in the brain bilaterally with functional asymmetries of the right hemispheric dominance in the right handers. Spatial working memory entails the ability to keep spatial information active in working memory over a short period of time which is also known as the right hemispheric dominance. Three patients (Pt 1, 32-year-old female; Pt 2, 18-year-old male; Pt 3, 63-year-old male) suffered from acute onset of vertigo. Pt 1 and 2’s examination revealed vestibular neuritis (VN) on the right side showing spontaneous left beating nystagmus and impaired vestibular ocular reflex (VOR) on the right side in video head-impulse and caloric tests. Pt 3’s finding was fit for VN on the left side. We also evaluated visuospatial memory function with the block design test in these three VN patients which discovered lower scores in Pt 1 and 2 and the average level in Pt 3 compare to those of healthy controls. Follow up block design test after resolved symptoms showed within normal range in both patients. Our cases suggest that the patients with unilateral peripheral vestibulopathy may have an asymmetrical effect on the higher vestibular cognitive function. The right VN can be associated with transient visuospatial memory dysfunction. These findings add the evidence of significant right hemispheric dominance for vestibular and visuospatial structures in the right-handed subjects, and of predominant dysfunction in the hemisphere ipsilateral to the peripheral lesion side.

Keywords: Vestibular neuronitis (VN); visuospatial memory; vestibular; block design; hemispheric dominance