Otolith dysfunction in vestibular neuritis: Recovery pattern and a predictor of symptom recovery
- Affiliated Author(s)
- 김현아; 홍정호; 이형; 이현아; 이성용; 이세엽; 장병철; 안병훈
- Alternative Author(s)
- Kim, Hyun Ah; Hong, Jeong Ho; Lee, Hyung; Yi, Hyon Ah; Lee, Seong Ryong; Lee, Se Youp; Jang, Byeong Churl; Ahn, Byung Hoon
- Journal Title
- Neurology
- ISSN
- 0028-3878
- Issued Date
- 2008
- 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.
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