Intravenous dexamethasone in acute management of vestibular neuritis: a randomized, placebo-controlled, single-blind trial

Adamec, Ivan; Skorić, Magdalena Krbot; Gabelić, Tereza; Barun, Barbara; Ljevak, Josip; Kovač, Andreja Bujan; Jurjević, Ivana; Habek, Mario

doi:10.1097/mej.0000000000000275

Cited by 10 publications

(27 citation statements)

References 14 publications

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“…Thus, 17 full articles were assessed for eligibility. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Two further records had to be excluded due to inconsistency of the inclusion criteria. 32,33 Finally, 15 studies were included in the quantitative and qualitative analysis.…”

Section: Search Resultsmentioning

confidence: 99%

“…As the studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] showed different outcome criteria, a re-coding was performed forming a composite endpoint. The following criteria were judged as good clinical outcome event in the acute phase (Outcome I):…”

Section: Evaluation Conceptmentioning

confidence: 99%

“…Any improvement in European evaluation of vertigo (EEV) scale after application of dexamethasone after 120 min. 29 The second success criterion was the result of vestibular laboratory testing in the follow-up, ranging between 1 19 or 6 and 24 months 21 (Outcome II):…”

Section: Evaluation Conceptmentioning

confidence: 99%

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Corticosteroids in patients with vestibular neuritis: An updated meta‐analysis

Bogdanova

Dlugaiczyk

Heckmann

et al. 2022

Acta Neuro Scandinavica

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Section: Search Resultsmentioning

confidence: 99%

Section: Evaluation Conceptmentioning

confidence: 99%

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Corticosteroids in patients with vestibular neuritis: An updated meta‐analysis

Bogdanova

Dlugaiczyk

Heckmann

et al. 2022

Acta Neuro Scandinavica

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“…The duration of the corticosteroid intervention ranged from 1 to 21 days. The most common corticosteroids used were dexamethasone 21,22,26 and methylprednisolone. 13,23,25 Records idenƟfied through database searching (n = 1375) Treatment: (n = 51) dexamethasone 12 mg (IV), diazepam 10 mg in 500 mL of 0.9% saline (IV), and thiethylperazine 6.5 mg subcutaneously.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Systematic Review and Meta‐analysis: Effectiveness of Corticosteroids in Treating Adults With Acute Vestibular Neuritis

Leong

Lau

Stewart

et al. 2021

Otolaryngol.--head neck surg.

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Objectives To determine whether steroids are effective in treating adults with acute vestibular neuritis. Data Sources PubMed, Embase, CINAHL, Cochrane CENTRAL, Web of Science, CAB Abstract, ICTRP, LILACS, PEDRO, ClinicalTrials.Gov, Google Scholar, NARIC, and OT Seeker. Review Methods A systematic review was undertaken for articles reporting subjective and/or objective outcomes of corticosteroids in adults with acute vestibular neuritis between December 2010 and October 2019. Reports of patient recovery from clinical vestibular outcomes at various time points and adverse effects from corticosteroids were of interest. Statistical analysis included qualitative and quantitative assessments. A limited meta-analysis of the data was performed through a random effects model. Results Eight studies met the criteria, and 6 were included in the meta-analysis. No significant differences between the groups (corticosteroid vs placebo, corticosteroid vs vestibular exercise, or corticosteroid vs combination of vestibular exercise and corticosteroid) were reported in the proportion of patients with complete recovery at 1, 6, and 12 months. The corticosteroid group had significantly better caloric recover at 1 month (95% CI, –16.33 to –0.32); however, there was no significant difference to the overall effect between the groups across 12 months. Subjective recovery did not differ between the groups. Five of the 8 studies reported on adverse effects from corticosteroids. Conclusion There is insufficient evidence to support the use of corticosteroids in managing acute vestibular neuritis in adults. At present, corticosteroids appear to have short-term benefits in canal paresis but no long-term benefits in canal paresis and symptomatic recovery. Future studies should consider including a wider variety of clinical vestibular tests and frequent acute follow-ups to monitor the effects of corticosteroids.

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“…Vestibular rehabilitation training can accelerate the recovery of patients with acute vestibular neuritis and reduce the disability degree of patients with permanent vestibular injury. It has a certain positive effect on the longterm recovery of patients as well as the recovery of balance function (14,15). Training methods mainly include fixation stability visual tracking training, static and dynamic posture stability training, and functional activity training (16).…”

Section: Introductionmentioning

confidence: 99%

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

Xiaohua¹,

Li²,

Yan³

2022

Ann Palliat Med

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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.

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Intravenous dexamethasone in acute management of vestibular neuritis: a randomized, placebo-controlled, single-blind trial

Abstract: The value of dexamethasone cannot be established, given the small sample and limitations of the present study. Some observations consistent with clinical improvement cannot exclude a true treatment effect, and further study is still warranted.

Cited by 10 publications

References 14 publications

Corticosteroids in patients with vestibular neuritis: An updated meta‐analysis

Corticosteroids in patients with vestibular neuritis: An updated meta‐analysis

Systematic Review and Meta‐analysis: Effectiveness of Corticosteroids in Treating Adults With Acute Vestibular Neuritis

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

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