Vestibular Neuritis and Bilateral Vestibulopathy.
10.5124/jkma.2008.51.11.992
- Author:
Kwang Dong CHOI
1
;
Eui Kyung GOH
Author Information
1. Department of Neurology, Pusan National University Medical School, Korea. choikwangdong@hanmail.net
- Publication Type:Original Article
- Keywords:
Vestibular neuritis;
Bilateral vestibulopathy;
Peripheral vestibulopathy
- MeSH:
Adrenal Cortex Hormones;
Antiviral Agents;
Caloric Tests;
Ear Diseases;
Ear, Inner;
Gait;
Head;
Head Movements;
Hearing Loss;
Hearing Tests;
Inflammation;
Ischemia;
Meningitis;
Reflex, Vestibulo-Ocular;
Vertigo;
Vestibular Nerve;
Vestibular Neuronitis;
Visual Acuity;
Walking
- From:Journal of the Korean Medical Association
2008;51(11):992-1006
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Vestibular neuritis is the second most common cause of peripheral vestibular vertigo. The key signs and symptoms are the acute onset of sustained rotatory vertigo without hearing loss, postural imbalance with Romberg's sign, and peripheral type nystagmus. Head thrust and caloric tests show ipsilateral hyporesponsiveness, but hearing test shows normal. Either an inflammation of the vestibular nerve or labyrinthine ischemia was proposed as a cause of vestibular neuritis. Recovery after vestibular neuritis is usually incomplete. Despite the assumed viral cause, the effects of corticosteroids, antiviral agents, or the two in combination are uncertain. Bilateral vestibulopathy is a rare disorder of the peripheral labyrinth or the eighth nerve. The most frequent etiologies include ototoxicity, autoimmune disorders, meningitis, neuropathies, sequential vestibular neuritis, cerebellar degeneration, tumors, and miscellaneous otological diseases. The two key symptoms are unsteadiness of gait and oscillopsia associated with head movements or when walking. The diagnosis is made with the simple bedside tests for defective vestibulo-ocular reflex (head thrust and dynamic visual acuity tests). Bilateral vestibulopathy is confirmed by the absence of nystagmus reaction to both caloric and rotatory chair tests. The spontaneous recovery is relatively rare and incomplete. Vestibular rehabilitation is supportive of the improvement, but the efficacy of physical therapy is limited.
