Vertigo Consistent with the so-called Vestibular Neuronitis after Influenza Vaccination

Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

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“…Immunologic mechanisms have been suggested as possible causes for vestibular neuritis following influenza vaccination [ 58 ].…”

Section: Immunological Hypothesismentioning

confidence: 99%

Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

Greco

Macrì

Gallo

et al. 2014

Journal of Immunology Research

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“…In these syndromes, the fact that infectious virus can no longer be isolated from the brain or the cerebrospinal fluid led to the hypothesis that a transient viral infection of the brain is followed by an autoimmune‐mediated destruction of the tissue. In support of the possibility of a post‐viral infectious etiology of vestibular neuritis in a subset of patients, Hiyoshi and Sekitani 20 described one case of vestibular neuritis following immunization with influenza vaccine.…”

Section: Discussionmentioning

confidence: 99%

Histopathology of Idiopathic Chronic Recurrent Vertigo

Ishiyama

López

et al. 1996

The Laryngoscope

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Vestibular neuritis is a degenerative neuropathy of the peripheral vestibular system. The etiology of this condition is uncertain, although it is generally believed to be viral. A small percentage of patients with vestibular neuritis have chronic recurrent episodes of vertigo. Detailed cytologic descriptions of acute or chronic vestibular neuritis are lacking, and no previous studies have reported evidence of chronic inflammation in human temporal bone specimens. The authors of this study examined temporal bone specimens from three patients with a history of chronic recurrent vertigo of unknown cause. Varying degrees of inflammation and destruction were seen in the vestibular system, and mild involvement of the cochlear system was noted. These findings are consistent with postinfectious inflammatory changes of the cochlear-vestibular system analogous to a postinfectious syndrome involving the central nervous system.

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“…Immune system, inflammation, and glucocorticoids Since Hiyoshi and Sekitani [83] discovered a possible association between the onset of AUV and influenza vaccination, immunological mechanisms have been formally implicated in the etiology of AUV [84]. Bumm and Schlimok [85] later identified similarities between lymphocyte subpopulations and HLA-DR determinations in diseases of the inner ear and Bell's palsy.…”

Section: Causal Treatmentmentioning

confidence: 99%

Pharmacological Treatment of Acute Unilateral Vestibulopathy: A Review

Sousa,

Alves,

Pinto

et al. 2024

J Audiol Otol

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There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment.

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Vertigo Consistent with the so-called Vestibular Neuronitis after Influenza Vaccination

Cited by 5 publications

References 0 publications

Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

Histopathology of Idiopathic Chronic Recurrent Vertigo

Pharmacological Treatment of Acute Unilateral Vestibulopathy: A Review

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