Efficacy of steroid therapy based on symptomatic and functional improvement in patients with vestibular neuritis: a prospective randomized controlled trial

Yoo, Myung Hoon; Yang, Chan Joo; Kim, Shin Ae; Park, Marn Joon; Ahn, Joong Ho; Chung, Jong Woo; Park, Hong Ju

doi:10.1007/s00405-017-4556-1

Cited by 33 publications

(104 citation statements)

References 33 publications

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“…Several researchers have demonstrated beneficial clinical application of corticosteroids [7] [8]. On the other hand, Yoo et al [9] reported that there were no significant differences between the control group and the steroid group. It is clear that not all patients are cured by corticosteroid therapy because 3 patients enrolled in the present study did not recover, in spite of early treatment with steroids.…”

Section: Discussionmentioning

confidence: 99%

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Ichijo¹

2018

IJOHNS

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Objective: To clarify whether vestibular rehabilitation is effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Methods: The subjects were 8 patients (6 females and 2 males) with vestibular neuritis who revealed long-lasting (more than 2 months since the onset) horizontal spontaneous nystagmus toward the healthy side. We used thumbs-up head shaking for vestibular rehabilitation. This exercise involves active head shaking (1 Hz) while staring at one's thumb nail. One set is 10 cycles. We asked the patient to do 3 sets (morning, afternoon, and night) every day. Results: The mean value of the slow-phase velocity of spontaneous nystagmus before treatment was 4.1˚/s, and that 3 months after vestibular rehabilitation was 4.1˚/s. No improvement was observed. Conclusion: Vestibular rehabilitation is not always effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Therefore, clinicians should consider the possibility of long-term incomplete central compensation.

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Section: Discussionmentioning

confidence: 99%

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Ichijo¹

2018

IJOHNS

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“…In the clinical course of VN, the normalization rate of the caloric test is known to be 40-66% after 6 months to 1 year. 17,23,32,34,38,39) In the case of vHIT, the normalization rate was reported to be higher than that of the caloric test. 17) In other studies, the normalization rate of the lateral canal gain in the lesion was 38-52% at 1 month after onset and 79-87% at 6 months after onset using vHIT.…”

Section: Clinical Course and Follow-upmentioning

confidence: 94%

“…This finding was in contrast with previous reports using a caloric test that showed the effectiveness of steroids. 32) The discrepancies between the evaluation of the lateral semicircular canal function using the vHIT and canal paresis in the caloric test are relatively well known, especially in Meniere's disease. The discrepancies in Meniere's disease are explained by two theories; first, as we know, there are type I and type II hair cells, and type II hair cells (which usually does not response to high frequency stimulus) are more frequently affected in Meniere's disease, so vHIT can be frequently pre- Fig.…”

Section: Clinical Course and Follow-upmentioning

confidence: 99%

“…44) The rate of improvement (normalized to within 10) of DHI in VN has been reported to be approximately 64% to 87%. 27,32) However, the association between the severity of dizziness symptoms and vHIT gain has been reported differently in studies. Patel, et al 44) found that the severity of dizziness evaluated using DHI and the Vertigo Symptoms Scale short-form in patients with chronic stage VN was not significantly correlated with the results of vHIT.…”

Section: Clinical Course and Follow-upmentioning

confidence: 99%

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Clinical Application of Video Head Impulse Test in Acute Vestibular Syndrome

Yoo¹

2020

Korean J Otorhinolaryngol-Head Neck Surg

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Acute unilateral vestibulopathy (AUV) is the recommended term [rather than the more widely used 'vestibular neuritis (VN)'] for all pathologies involving sudden impairment of the unilateral peripheral vestibular function regardless of the exact location of the lesion. Acute vestibular syndrome (AVS) is an upper-level entity of AUV, which is the most common cause of AVS, and includes acute central vertigo. AVS typically presents with the symptoms of new onset continuous vertigo, gait instability, and nausea/vomiting lasting several days to weeks. The video head impulse test (vHIT) was recently developed and has been widely adopted at clinics and emergency centers. In this study, we will review the differential diagnosis of AVS using vHIT. In addition, we will describe the subtypes of VN and the use of vHIT for follow-up testing in AVS.

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“…Further research into VN is warranted since the efficacy of current therapies is in question. A recent randomized controlled trial showed no value for the addition of methylprednisolone to conventional therapy [38], others had shown negative results for aminopyridine [19]. Peripheral causes (presumably leading to atrophy of the SVN) should be treated differently from centrally mediated causes without atrophy.…”

Section: Consequencesmentioning

confidence: 99%

Vestibular Nerve Atrophy After Vestibular Neuritis – Results from a Prospective High-Resolution MRI Study

Freund

Weber²,

Schneider

et al. 2020

Rofo

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Purpose Sudden unilateral peripheral vestibular deficit is mostly termed vestibular neuritis (VN), even if its cause or the exact location of the lesion remains unclear. Thus, therapy is mostly symptomatic. We aimed to prove if there is peripheral atrophy after VN with persistent canal paresis. Methods After approval by the ethics committee and according to the declaration of Helsinki and with informed consent, ten patients with persistent canal paresis after VN and ten age-matched healthy controls were included. High-resolution measurement (in-plane resolution 0.2 mm) of the internal auditory canal (IAC) using a 3 D CISS sequence at 3 Tesla was performed. The course of the pertaining nerves was reconstructed in the 3 D dataset and the measurement was performed at 60 % of the length of the IAC. The cross-sectional areas of the superior (SVN) and inferior vestibular nerve (IVN) were taken independently by two blinded readers. Results The interrater difference regarding the area was 22 %. We found significant atrophy of the SVN with a 24 % smaller area (p = 0.026) and found a smaller ratio of SVN/IVN on the symptomatic side (p = 0.017). Concerning single subject data, only 5 patients showed extensive atrophy of the NVS, while 5 patients did not. The time since symptom onset did not significantly influence the atrophy. Conclusion MRI measuring of the area of the NVS after VN could detect atrophy after VN. However, only 5 patients exhibited marked atrophy, while the other 5 patients did not. With the background of stringent inclusion criteria (more than 6 months of symptom duration and proven persistent canal paresis), one has to wonder if there might be different etiologies behind the apparently identical symptoms. Key Points: Citation Format

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Efficacy of steroid therapy based on symptomatic and functional improvement in patients with vestibular neuritis: a prospective randomized controlled trial

Abstract: Clinicaltrials.gov Identifier, NCT02098330; Trial title, The Efficacy of Steroid Therapy in Vestibular Neuritis.

Cited by 33 publications

References 33 publications

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis

Clinical Application of Video Head Impulse Test in Acute Vestibular Syndrome

Vestibular Nerve Atrophy After Vestibular Neuritis – Results from a Prospective High-Resolution MRI Study

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