No abstract available.
Diplopia ; Vestibular Neuronitis

Humans ; Vestibular Neuronitis/therapy*

OBJECTIVE: Vestibular neuritis (VN) is one of the most common causes of acute spontaneous vertigo. However, such dizziness symptoms in patients with VN vary among patients, and various methods are used to evaluate subjective vestibular symptoms following attack of VN. Studies on correlation between subjective vestibular symptom changes and result of rotation chair test after vestibular rehabilitation therapy (VRT) have not been reported. Therefore, we compared change of dizziness handicap inventory (DHI) and results of rotation chair test in patients with VN between attack and 3 month later following VRT. METHODS: Forty-seven patients were included in this study. In patients with VN, DHI and rotation chair test were performed at the time of VN attack and recovery time of 3 months after VN attack. RESULTS: In general, the DHI score and the percentage of directional preponderance (DP) in a rotation chair test performed on patients with VN have all decreased. However, the changes in these results were not statistically significant. DP% difference and DHI score were compared to each other among patients with VN and showed no relational significance to each other (r=0.326). CONCLUSION: The degree of improvement in a rotation chair test done on patients with VN did not reflect the severity of improvement for symptom like dizziness.
Dizziness ; Humans ; Rehabilitation ; Vertigo ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: Subjective visual vertical (SVV) and subjective visual horizontal (SVH) are well known otolith function tests. Patients with acute unilateral vestibular weakness have a tendency to set the bar toward the side of the lesion in SVV and SVH tests. The object of this article is to identify the effect of preset angle on SVV and SVH tests in normal subjects and patients with dizziness. MATERIALS AND METHODS: From October 2008 to March 2009, thirty healthy volunteers, twenty eight vestibular neuritis (VN) patients (14-uncompensated, 14-compensated), Twenty five patients who had migrainous vertigo (MV) were enrolled. All subjects performed the test two times in each of the clockwise and counter-clockwise preset angle. RESULTS: In normal subjects, there was significant influence by preset angle on SVV test, not on SVH test. In VN patients with nystagmus, both SVH and SVV were not influenced by preset angle. In VN patients without nystagmus and in MV patients, there were significant influence by preset angle on both SVV and SVH tests. CONCLUSION: SVV and SVH values depend on the direction of the preset angle in MV and uncompensated VN patients. The preset angle should be considered in the interpretation of SVV and SVH values.
Dizziness ; Humans ; Otolithic Membrane ; Vertigo ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the results of high-frequency and high-acceleration rotary chair test in patients with acute unilateral vestibular neuritis. MATERIALS AND METHODS: Twenty-four patients who were diagnosed as acute vestibular neuritis and underwent rotational chair and caloric tests during March 2012 to March 2013 were included. Slow harmonic acceleration (SHA) test was performed at 0.01, 0.04, 0.16, 0.64, 1.28, and 2.00 Hz. Step velocity tests at the peak velocity of 100degrees/sec (low-acceleration) and 240degrees/sec (high-acceleration) were performed. Gains and phases in SHA test and gains and time constants (Tc) in step velocity test were analyzed. RESULTS: In SHA test, decreased gain and phase lead was observed mostly in low frequencies. Gains (phases) at 0.01, 0.04, 0.16, 0.64, 1.28, and 2.00 Hz were 0.2+/-0.1 (62.2+/-15.4), 0.3+/-0.2 (24.5+/-13.0), 0.4+/-0.2 (7.2+/-18.8), 0.5+/-0.1 (7.2+/-11.3), 0.7+/-0.2 (11.0+/-7.5), and 0.8+/-0.3 (4.4+/-14.4), respectively. In step velocity (SV) test, gains stimulating the lesion side were significantly lower than those stimulating the intact side in both low- and high-acceleration SV test (p<0.05) and per-rotatory gain stimulating the lesion side in high-acceleration SV test was significantly lower than that in low-acceleration SV test. Tc stimulating the lesion side were significantly shorter than those stimulating the intact side in low- acceleration SV test (p<0.05) but not in high-acceleration SV test. Per- and post-rotatory Tc in high-acceleration SV test stimulating the intact side was significantly lower than those in low-acceleration SV test (p<0.05). CONCLUSION: At high-frequency SHA test, gain was pretty normal and phase lead was observed in some patients. High-acceleration SV test showed shortened Tc regardless of the sides, suggesting that high-acceleration SV test can reveal the impaired velocity storage system in patients with vestibular neuritis more frequently than low-acceleration SV test.
Acceleration ; Caloric Tests ; Humans ; Vestibular Neuronitis

OBJECTIVE: Spontaneous nystagmus is typical sign in vestibular neuronitis. However, the clinical significance of spontaneous nystagmus frequency remains unclear. The aim of this study is to analyze the spontaneous nystagmus frequency in patients with vestibular neuronitis. METHODS: Twenty-five patients with vestibular neuronitis were included. Patients were divided good (≥20%) and poor (<20%) group according to change of spontanous nystagmus frequency. Frequency and velocity of spontaneous nystagmus were analyzed by using video-nystagmography. Caloric test and slow harmonic acceleration test were also performed. RESULTS: There was a positive linear correlation between frequency and velocity in initial and follow test (R2=0.51, 0.43, p<0.01, p<0.01). Also, there was a strong positive linear correlation betweeng change of frequency and change of velocity (R2=0.64, p<0.01). The phase lead of slow harmonic acceleration test of good group was smaller compared with poor group, and this was statistically significant in 0.04 Hz. CONCLUSION: We suggested that frequency of spontaneous nystagmus may be a useful clinical factor in vestibular neuronitis.
Acceleration ; Caloric Tests ; Humans ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: There are caloric test, SCEP, DP in Step velocity and VOR asymmetry in SHA test as parameters for evaluation in unilateral peripheral vestibulopathy in parameter of vestibular function test. The aim of this study is to assess the correlation between these parameters and intensity of spontaneous nystagmus in vestibular neuritis. MATERIALS AND METHOD: We evaluated 75 patients who were diagnosed as vestibular neuritis with 3 degree spontaneous nystagmus at vestibular function test lab from January 2000 to July 2005 in Dankook university hospital. The correlations between direction and intensity of spontaneous nystagmus and monothermal caloric test, SCEP and DP in step velocity, VOR asymmetry (0.01, 0.04, 0.16 Hz) in SHA test were analysed. And correlations according to sex, age were also analysed. RESULTS: The correlation coefficient between intensity of spontaneous nystagmus and monothermal caloric test was 0.60. The correlation coefficient between intensity of spontaneous nystagmus and SCEP was 0.35. The correlation coefficient between intensity of spontaneous nystagmus and Tc DP was 0.36 and it showed no significant correlation. The correlation coefficient between intensity of spontaneous nystagmus and VOR asymmetry (0.01, 0.04, 0.16) was 0.57, 0.46, 0.51, respectively and there was higher correlation in man, age under 60. CONCLUSION: Intensity of spontaneous nystagmus showed close relations to monothermal caloric test, VOR asymmetry of SHA, Tc DP, SCEP DP in sequence. In addition, young male patients tends to be closely related to intensity of spontaneous nystagmus.
Caloric Tests ; Humans ; Male ; Vestibular Function Tests* ; Vestibular Neuronitis*

Vestibular neuritis is generally thought to be caused by a viral or postviral inflammatory disorder of vestibular structures. But there is no definite evidence to explain this pathophysiological mechanism until now. We experienced an unusual case of 34-year-old man who presented with facial paralysis several days after vertigo of a whirling nature. We report a case of facial palsy developed in succession of ipsilateral vestibular neuritis involving superior vestibular nerve which may infer the viral pathophysiology for the vestibular neuritis with a brief literature review.
Adult ; Facial Paralysis ; Humans ; Vertigo ; Vestibular Nerve ; Vestibular Neuronitis

Objective: The aim of the study is to analyze the effects of vestibular spontaneous nystagmus(SN) on the smooth pursuit function of visual ocularmotor system. Methods: A total of 46 patients with acute unilateral peripheral vestibular syndrome with SN (26 cases of vestibular neuritis, 6 cases of Ramsay Hunt Syndrome (RHS) with vertigo, 14 cases of sudden deafness with vertigo) were included in this work. In the study group, the results of SPT and SN test with videonystagmography(VNG) were also reviewed. Taking SPT parameters, the influence of SN intensity on SPT gain, asymmetry and waveform and their correlation were analyzed.SPSS19.0 software was used for statistical analysis. Results: Among the 46 patients, there were 36 cases of SN pointing to the healthy side(SN intensity range of 2.68°/s-32.53°/s), and 10 cases of SN pointing to the affected side (SN intensity range of 2.66°/s-16.54°/s). SN intensity was divided into 3 groups, including light(0.50°/s-5.00°/s), medium(5.01°/s-10.00°/s) and strong(>10.01°/s), accounting for 14 cases(30.4%), 18 cases(39.1%) and 14 cases(30.4%), respectively. The differences of the gain of SPT to the fast phase and slow phase direction in the overall groups and light, medium and strong groups of SN intensity respectively were statistically significant(t_total=13.338, t_light=6.184, t_medium=8.436, t_strong=8.477, all of P<0.001). The difference of SPT gain in SN fast phase direction between groups with different SN intensity was statistically significant(F=9.639, P<0.001),there was no statistically significant difference in SPT gain between the groups on the SN slow phase direction(F=1.137, P=0.330).The SN intensity significantly negatively correlated with the SPT gain of the fast phase direction of SN (r=-0.433, P=0.003), that was, the SPT gain on the fast phase direction of SN decreased with the increase of SN intensity. There was no significant correlation between SN intensity and the gain of SPT on the slow phase direction of SN (r=-0.061, P=0.687). SPT waveform analysis showed that type I, type II and type III accounted for 8 cases(17.4%), 21 cases(45.6%) and 17 cases(37.0%), respectively. The corresponding mean values of SN intensity were (3.71±0.69)°/s, (7.44±1.88)°/s, (20.04±5.53)°/s, respectively, without type IV wave. The intensity of SN was positively correlated with the asymmetric value of the gain of SPT left and right(r=0.450,P=0.002). That was, with the increase of SN strength, the asymmetric value also increased, and the worse the asymmetry of the gain of SPT left and right pursuit was, the worse the SPT waveform was. Conclusion: SPT gain, asymmetry and SPT waveforms are all affected by SN, and the greater the intensity of SN, the greater the influence on the three. When SN is strong, type III waves may occur, suggesting that acute peripheral vestibular syndrome can also affect the visual ocularmotor systems.
Humans ; Nystagmus, Pathologic ; Pursuit, Smooth ; Vertigo ; Vestibular Diseases ; Vestibular Function Tests ; Vestibular Neuronitis

BACKGROUND AND OBJECTIVES: While it is known that sleep have influence on emergence of rapid eye movements (REMs), namely saccades including fast component of nystagmus, whether spontaneous nystagmus due to vestibular imbalance presents during sleep is still unclear. The purpose of our study was to investigate whether tonic vestibular imbalance appeared as spontaneous nystagmus during the wakeful state could present during REM sleep. MATERIALS AND METHOD: Overnight polysomnography (PSG) was performed in 7 patients with spontaneous nystagmus due to vestibular neuritis (VN) and 7 control patients without dizziness or any nystagmus. The numbers of horizontal saccades were counted, during 3 minutes samples of the alert state before and after the PSG and the first and last REM sleep. RESULTS: All patients with VN showed significantly more saccades (fast phases of spontaneous nystagmus) towards the side contralateral to their vestibular lesion in the awake state before and after the PSG compared with control group. By contrast, during REM sleep the patients with VN showed no preponderance in saccade direction (p<0.05). Some brief nystagmoid jerks showed during REM sleep in both patients and controls equally and also had no preponderance in direction. CONCLUSION: The tonic vestibular imbalance at peripheral level observed during alert state does not appear at the brainstem level during REM sleep. It is suggested that a de-afferentation of the peripheral vestibular input to the REM sleep generating areas may explain an absence of nystagmus during REM sleep in patients with VN.
Brain Stem ; Dizziness ; Humans ; Polysomnography ; Saccades ; Sleep, REM ; Vestibular Neuronitis*