Update on Vertigo in Autoimmune Disorders, from Diagnosis to Treatment

Abstract

The prevalence of autoimmune diseases has been increasing over the last 20 years. The clinical presentation of this large and heterogeneous group of disorders depends on whether the involvement is organ-specific or non-organ-specific. Dizziness, vertigo, and disequilibrium are common symptoms reported by patients with vestibulocochlear involvement. The association of vertigo and autoimmune diseases has been largely documented, suggesting that autoimmune disorders could be overrepresented in patients with vertigo in comparison to the general population. The aim of this review is to present the recent literature findings in the field of autoimmune-mediated diseases with cochleovestibular involvement, focusing on the clinical presentation, diagnosis, and treatment of immune-mediated inner ear diseases including autoimmune inner ear disease (AIED), Meniere's disease, and bilateral vestibulopathy, as well as of systemic autoimmune diseases with audiovestibular disorders, namely, Behçet's disease, Cogan's syndrome, sarcoidosis, autoimmune thyroid disease, Vogt-Koyanagi-Harada syndrome, relapsing polychondritis, systemic lupus erythematosus, antiphospholipid syndrome, IgG4-related disease, and ANCA-associated vasculitides.

Can Hashimoto's thyroiditis cause vertigo? [Czy choroba Hashimoto może być przyczyną zawrotów głowy?]

“…gentamicin, furosemide) [39,40]. In the 1990s, an autoimmune basis of the disease was suspected [41][42][43][44][45]. The condition is manifested by sudden, severe vertigo (spinning sensation), resulting from sudden unilateral weakness or loss of labyrinth function.…”

“…Although almost every patient who is hospitalised due to vestibular neuritis is routinely assessed for thyroid disorders, to the best of our knowledge, there are no objective study results that could confirm the relationship between these two diseases. According to Girasoli et al, immune-mediated vestibular disorders are rare and difficult to diagnose [43]. Those authors emphasised the lack of objective tests to confirm immune processes that occur in the structures of the inner ear, which could directly contribute to vertigo.…”

“…W latach 90. Wskazywano na możliwe podłoże autoimmunologiczne choroby [41][42][43][44][45]. Choroba objawia się nagłymi, ciężkimi zawrotami głowy o typie wirowym, wynikającymi z jednostronnego nagłego osłabienia bądź wypadnięcia funkcji błędnika.…”

“…Zaburzenia narządu przedsionkowego o podłożu immunologicznym są rzadkie i trudne do zdiagnozowania, czego dowodzi w swojej pracy Girasoli i wsp. [43]. Autorzy słusznie podkreślają brak, jak dotąd, obiektywnych testów potwierdzających procesy immunologiczne mające zachodzić w strukturach ucha wewnętrznego, a które bezpośrednio miałyby się przyczyniać do występowania zawrotów głowy.…”

Epidemiology and Seasonal Variation of Ménière’s Disease: Data from a Population-Based Study

“…Ménière's disease (MD) is a multifactorial disorder of the inner ear characterized by vertigo, tinnitus, and sensorineural hearing loss [Girasoli et al, 2018]. MD is characterized by fluctuating symptoms and episodic attacks, and it has been suggested that dietary components and stress are associated with MD attacks and symptom spikes [Kirby and Yardley, 2012].…”