Otolith dysfunction in vestibular neuritis: Recovery pattern and a predictor of symptom recovery

Authors
H.-A. KimJ.-H. HongH. LeeH.-A. YiS.-R. LeeS.-Y. LeeB.-C. JangB.-H. AhnR.W. Baloh
Department
Dept. of Neurology (신경과학); Dept. of Pharmacology (약리학); Dept. of Ophthalmology (안과학); Dept. of Molecular Medicine (분자의학); Dept. of Otorhinolaryngology (이비인후과학); Brain Research Institute (뇌연구소)
Issue Date
2008
Citation
Neurology, Vol.70(6) : 449-453, 2008
ISSN
0028-3878
Abstract
Objectives: To prospectively follow patients with vestibular neuritis (VN), to compare the recovery pattern of canal and otolith dysfunction, and to determine which tests best predict symptom recovery. Methods: Between March 2006 and December 2006, 51 consecutive patients with unilateral VN were enrolled within 7 days of onset (average 3 days). Otolith function tests included ocular torsion (OT), subjective visual vertical (SVV), and vestibular evoked myogenic potential (VEMP), and canal function tests included head-shaking nystagmus (HSN), caloric stimulation, and head-thrust testing. Patients returned for two follow-up evaluations at approximately 1 week and 6 weeks after the initial evaluation. Results: On the first examination, all patients had abnormal HSN, caloric, and head-thrust test results, and at least one otolith-related test abnormality: abnormal tilt of SVV (48/51, 94%), abnormal OT (42/51, 82%), or abnormal VEMPs (25/51, 49%). The degree of SVV tilts correlated with the degree of OT for one or both eyes (p 0.05). Skew deviation was observed in 7 patients (14%), and a complete ocular tilt reaction was detected in only 2 patients. On follow-up, otolith test results returned to normal more rapidly than canal test results. The head-thrust test was the best predictor of symptom recovery. Eighty percent of patients who continued to report dizziness at the last follow-up visit had a positive head-thrust test result, whereas only 10% of patients who were not dizzy had a positive head-thrust test result. Conclusion: Otolith-related test abnormalities improve more rapidly than canal-related test abnormalities after vestibular neuritis. If patients have a positive head-thrust test result on followup, they are more likely to be dizzy.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/33517
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Pharmacology (약리학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Ophthalmology (안과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Molecular Medicine (분자의학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학)
1. Journal Papers (연구논문) > 3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
Keimyung Author(s)
김현아; 홍정호; 이형; 이현아; 이성용; 이세엽; 장병철; 안병훈
Full Text
http://n.neurology.org/content/70/6/449.long
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