Efficacy and safety of mecobalamin combined with vestibular rehabilitation training for acute vestibular neuritis: a systematic review and meta-analysis

Abstract

Background: This study aimed to investigate the efficacy and safety of mecobalamin combined with vestibular rehabilitation training in acute vestibular neuritis and to improve the clinical therapeutic effect in vestibular nerve disease. Methods:We performed a literature search of the PubMed, Medline, China National Knowledge Infrastructure (CNKI), and other databases from the date of establishment of the database until the present.The search terms included "mecobalamin", "vestibular rehabilitation training", "vestibular rehabilitation therapy", and "vestibular neuritis". References of the comparative study of vestibular rehabilitation training and vestibular rehabilitation training combined with mecobalamin were screened. Boolean logic retrieval was adopted, and Review Manager software was employed.Results: Meta-analysis was conducted on a total of four studies with a low risk of bias. The activities specific balance confidence scale (ABC) scores of the two groups were heterogeneous (Chi 2 =8.56, I 2 =88%, P=0.003), and a fixed-effect model (FEM) analysis indicated that there were no significant differences in the ABC between the groups after treatment (Z=0.67, P=0.50). It may be that mecobalamin combined with vestibular rehabilitation training effectively alleviated the symptoms of vestibular neuritis in the experimental group, thereby reducing the canal paresis (CP) value. In addition, there was no heterogeneous dizziness handicap inventory (DHI) between the groups after treatment (Chi 2 =20.75, I 2 =86%, P=0.0001); finite element method (FEM) analysis showed that the DHI of the experimental group after 6 months of treatment was notably lower compared to that of the control group (Z=3.20, P=0.001).Discussion: Mecobalamin combined with vestibular rehabilitation training can effectively improve vertigo and other symptoms of acute vestibular neuritis patients, with high effectiveness and safety.

Effect of mecobalamin combined with holographic copper acupuncture and scraping technique on tinnitus symptoms in patients with sudden sensorineural hearing loss

“…The results suggest that this combination is more effective in treating patients with sudden sensorineural hearing loss than methylcobalamin treatment alone. This could be due to the stimulation of catecholamine release, further generating endothelial relaxation factors, leading to vasodilation and improved blood circulation [18]. Simultaneously, the combined use of holistic copper acupuncture and scraping technique can promote the utilization of glucose and oxygen in ischemic tissues, accelerate local microcirculation, and improve inner ear microcirculation.…”

Comparison of Halmágyi–Curthoys Head Impulse (Thrust) Test with Romberg’s Test in Detection of Vestibular Hypofunctioning in Vertigo Patients

“…Romberg's test: Postural stability during quiet standing was evaluated with patients in various conditions, including eyes open and closed. Deviations from the expected postural stability were noted [23].…”

“…By analyzing the kinematics of these movements, ultrasound craniocorpography can provide insightful data on the dynamics of the vestibulospinal reflex and its relationship to postural control. However, it is important to note that each testing method has its unique advantages and limitations, necessitating careful consideration when selecting the appropriate assessment strategy based on the clinical scenario [23].…”

Effects of vestibular rehabilitation training combined with anti-vertigo drugs on vertigo and balance function in patients with vestibular neuronitis: a systematic review and meta-analysis

“…And whether to combine steroid drugs with VRT is an issue that needs to be considered. Most recently, Huang et al (28) compared steroid drugs combined with VRT as an intervention method in the experimental group with steroid drugs in the control group, and the outcome indicators included DHI score, caloric lateralization and VEMPs. It was concluded that steroid drugs combined with VRT was more effective than steroid alone.…”