Jung-Yup Lee1, Jin Su Park, Min-Beom Kim. 1. Department of Otolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To analyze the clinical characteristics of acute vestibular neuritis (AVN) according to involvement site. STUDY DESIGN: Retrospective chart analysis. SETTING: Tertiary referral hospital. PATIENTS/ INTERVENTIONS: Over a period of 3 years, we reviewed 133 cases of AVN. Patients were classified into three groups: 1) total vestibular neuritis (superior and inferior vestibular nerve involvement [TVN]); 2) superior vestibular neuritis (superior vestibular nerve involvement [SVN]); and 3) inferior vestibular neuritis (inferior vestibular nerve involvement [IVN]). MAIN OUTCOME MEASURE: We analyzed the clinical course and results of vestibular function tests (video-nystagmography, video head impulse test [vHIT], caloric test, and cervical vestibular evoked myogenic potential). RESULTS: In the study, there were 39.9% TVN cases, 48.1% SVN cases, and 12% IVN cases. The number of days to spontaneous nystagmus remission, hospital duration, and follow-up period were shorter in the IVN group than in the SVN and TVN groups. The symptom onset period was longer in the IVN group than in the SVN and TVN groups. Spontaneous nystagmus and head shaking nystagmus amplitude were smaller in the IVN group than in the SVN and TVN groups. Concordance of results between the caloric test, cervical vestibular evoked myogenic potential, and vHIT was relatively low in the IVN group. CONCLUSION: The IVN group had a shorter clinical course and weaker nystagmus in comparison with the TVN and SVN groups. The use of additional vHIT in the diagnosis of AVN can help provide a more accurate diagnosis of the rare subtype of IVN, which can be confused with various central lesions.
OBJECTIVE: To analyze the clinical characteristics of acute vestibular neuritis (AVN) according to involvement site. STUDY DESIGN: Retrospective chart analysis. SETTING: Tertiary referral hospital. PATIENTS/ INTERVENTIONS: Over a period of 3 years, we reviewed 133 cases of AVN. Patients were classified into three groups: 1) total vestibular neuritis (superior and inferior vestibular nerve involvement [TVN]); 2) superior vestibular neuritis (superior vestibular nerve involvement [SVN]); and 3) inferior vestibular neuritis (inferior vestibular nerve involvement [IVN]). MAIN OUTCOME MEASURE: We analyzed the clinical course and results of vestibular function tests (video-nystagmography, video head impulse test [vHIT], caloric test, and cervical vestibular evoked myogenic potential). RESULTS: In the study, there were 39.9% TVN cases, 48.1% SVN cases, and 12% IVN cases. The number of days to spontaneous nystagmus remission, hospital duration, and follow-up period were shorter in the IVN group than in the SVN and TVN groups. The symptom onset period was longer in the IVN group than in the SVN and TVN groups. Spontaneous nystagmus and head shaking nystagmus amplitude were smaller in the IVN group than in the SVN and TVN groups. Concordance of results between the caloric test, cervical vestibular evoked myogenic potential, and vHIT was relatively low in the IVN group. CONCLUSION: The IVN group had a shorter clinical course and weaker nystagmus in comparison with the TVN and SVN groups. The use of additional vHIT in the diagnosis of AVN can help provide a more accurate diagnosis of the rare subtype of IVN, which can be confused with various central lesions.
Authors: Ji-Soo Kim; David E Newman-Toker; Kevin A Kerber; Klaus Jahn; Pierre Bertholon; John Waterston; Hyung Lee; Alexandre Bisdorff; Michael Strupp Journal: J Vestib Res Date: 2022 Impact factor: 2.354