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

Freund, Wolfgang; Weber, Frank; Schneider, Daniel; Mayer, U.; Scheithauer, Marc O.; Beer, Meinrad

doi:10.1055/a-1110-7441

Cited by 8 publications

(7 citation statements)

References 33 publications

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“…A study on vestibular nerve atrophy magnetic resonance imaging (MRI) in VN observed a statistically significant decrease in the cross-sectional area and height of the vestibular nerve, compared to the parameters of the contralateral vestibular nerves [ 15 ]. However, another investigation showed that only half of the participants had vestibular nerve atrophy and the others did not [ 16 ]. Therefore, it can be concluded that vestibulo-ocular reflex (VOR) examinations are still of great importance, e.g., using the caloric test.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, previous research reported that persistent canal paresis resulted in significant atrophy of the superior vestibular nerve observed by MRI. However, since half of the patients did not show significant differences compared to the control group, these results should be confirmed, including a larger sample size [ 16 ]. Another study stated that the CP results were pathological in 76% of the follow-up stage, indicating a persistent CP value in the VN.…”

Section: Discussionmentioning

confidence: 99%

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Long-term follow-up of patients with vestibular neuritis by caloric testing and directional preponderance calculation

Molnár

Jassoy

Maihoub

et al. 2022

Eur Arch Otorhinolaryngol

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Objectives This study focuses on the diagnostic precision of caloric testing in detecting vestibular neuritis (VN). Materials and methods In this study, 99 patients (36 men, 63 women, mean age: 44.63 years $$\pm$$ ± 12.08 SD) with superior VN were involved, and 157 participants with a normal functioning vestibular system were also investigated. All patients underwent a complete neurotological examination, including the caloric test with electronystagmography registration. The canal paresis (CP) and directional preponderance (DP) values were analysed. Results A VN on the right side was diagnosed in 31.3% and on the left side in 68.7%. When the CP parameters between the control and VN patients were contrasted, a statistically significant difference was observed (p < 0.00001*, Mann–Whitney U test), indicating higher values in the latter group. The prediction of VN based on the CP value was successful in 71%, and statistical analysis indicated a significant result [p < 0.0001*; OR: 5.730 (95% CI 3.301–9.948)]. The DP values were also significantly higher in the VN group (p < 0.00001*). The prediction of VN according to the DP value was successful in 69.8%. A significant result was also observed in this case [p < 0.001*; OR: 4.162 (95% CI 2.653–8.017)]. When both CP and DP were considered, a predictive value of 84.8% with a significant outcome [p < 0.0001*; OR: 82.7 (95% CI 28.4–241.03)] was detected. Conclusions Including the CP and DP parameters of the caloric test, VN could be detected in around 85%. Therefore, the caloric helps diagnose the disorder, but both parameters must be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of patients with vestibular neuritis by caloric testing and directional preponderance calculation

Molnár

Jassoy

Maihoub

et al. 2022

Eur Arch Otorhinolaryngol

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“…Imaging studies can also demonstrate contrast enhancement of the vestibular nerve, in particular the superior vestibular nerve, one to four hours after gadolinium injection [26,47,153]. Finally, one study showed that high-resolution MRI examinations ≥ 6 months after symptom onset in patients with a persistent peripheral vestibular deficit revealed atrophy of the vestibular nerve in 5 of the 10 patients examined, in particular of the superior vestibular nerve [53].…”

Section: Imagingmentioning

confidence: 99%

Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria

Strupp¹,

Bisdorff

Furman

et al. 2022

VES

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This paper describes the diagnostic criteria for Acute Unilateral Vestibulopathy (AUVP), synonymous for vestibular neuritis, as defined by the Committee for the Classification of Vestibular Disorders of the Bárány Society. AUVP manifests as an acute vestibular syndrome due to an acute unilateral loss of peripheral vestibular function without evidence for acute central or acute audiological symptoms or signs. This implies that the diagnosis of AUVP is based on the patient history, bedside examination, and, if necessary, laboratory evaluation. The leading symptom is an acute or rarely subacute onset of spinning or non-spinning vertigo with unsteadiness, nausea/vomiting and/or oscillopsia. A leading clinical sign is a spontaneous peripheral vestibular nystagmus, which is direction-fixed and enhanced by removal of visual fixation with a trajectory appropriate to the semicircular canal afferents involved (generally horizontal-torsional). The diagnostic criteria were classified by the committee for four categories: 1. “Acute Unilateral Vestibulopathy”, 2. “Acute Unilateral Vestibulopathy in Evolution”, 3. “Probable Acute Unilateral Vestibulopathy” and 4. “History of Acute Unilateral Vestibulopathy”. The specific diagnostic criteria for these are as follows: “Acute Unilateral Vestibulopathy”: A) Acute or subacute onset of sustained spinning or non-spinning vertigo (i.e., an acute vestibular syndrome) of moderate to severe intensity with symptoms lasting for at least 24 hours. B) Spontaneous peripheral vestibular nystagmus with a trajectory appropriate to the semicircular canal afferents involved, generally horizontal-torsional, direction-fixed, and enhanced by removal of visual fixation. C) Unambiguous evidence of reduced VOR function on the side opposite the direction of the fast phase of the spontaneous nystagmus. D) No evidence for acute central neurological, otological or audiological symptoms. E) No acute central neurological signs, namely no central ocular motor or central vestibular signs, in particular no pronounced skew deviation, no gaze-evoked nystagmus, and no acute audiologic or otological signs. F) Not better accounted for by another disease or disorder. “Acute Unilateral Vestibulopathy in Evolution”: A) Acute or subacute onset of sustained spinning or non-spinning vertigo with continuous symptoms for more than 3 hours, but not yet lasting for at least 24 h hours, when patient is seen; B) - F) as above. This category is useful for diagnostic reasons to differentiate from acute central vestibular syndromes, to initiate specific treatments, and for research to include patients in clinical studies. “Probable Acute Unilateral Vestibulopathy”: Identical to AUVP except that the unilateral VOR deficit is not clearly observed or documented. “History of acute unilateral vestibulopathy“: A) History of acute or subacute onset of vertigo lasting at least 24 hours and slowly decreasing in intensity. B) No history of simultaneous acute audiological or central neurological symptoms. C) Unambiguous evidence of unilaterally reduced VOR function. D) No history of simultaneous acute central neurological signs, namely no central ocular motor or central vestibular signs and no acute audiological or otological signs. E) Not better accounted for by another disease or disorder. This category allows a diagnosis in patients presenting with a unilateral peripheral vestibular deficit and a history of an acute vestibular syndrome who are examined well after the acute phase. It is important to note that since there is no definite test for AUVP. Therefore, its diagnosis requires the exclusion of central lesions as well as a variety of other peripheral vestibular disorders. Finally, this consensus paper will discuss other aspects of AUVP such as etiology, pathophysiology and laboratory examinations if they are directly relevant to the classification criteria.

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“…Patients with VN suffer from persistent vertigo and fear of exercise, leading to exacerbation of the disease and a vicious cycle that affects treatment outcomes [ 16 ]. This study, through cognitive, medication, and rehabilitation therapy, may improve patient motivation for rehabilitation and contribute to improved balance function and reduced severity of condition [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Health Promotion Combined with Psychological Care Improves Vestibular Function in Patients with Vestibular Neuritis

Peng

Mei²,

Liu

et al. 2022

Contrast Media & Molecular Imaging

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This study aimed to explore the effect of health education combined with psychological care on patients with vestibular neuritis and the effect on their vestibular function. One hundred patients with vestibular neuritis admitted to our hospital from January 2019 to December 2020 were enrolled and divided into two groups by the random number: the control group (CG) (n= 53, health education) and the study group (SG) (n= 47, health education + psychological care). The Dizziness Handicap Inventory (DHI) scores, Berg Balance Scale (BBS) scores, depression scores (SDS), anxiety scores (SAS), satisfaction with care, compliance, incidence of falls, quality of life (QOF), and clinical symptom scores were compared between the two groups. Compared with the CG, the SG had a more significant reduction in DHI scores and SDS and SAS scores and a significant increase in BBS scores ( P < 0.05 ). Compared with the CG, the SG had higher nursing satisfaction and compliance and a lower incidence of falls ( P < 0.05 ). Nursing efficiency was higher in the SG than in the CG ( P < 0.05 ). QOF scores were higher in the SG than in the CG ( P < 0.05 ). Clinical symptom scores were lower in the SG than in the CG ( P < 0.05 ). Health education combined with psychological care can improve vestibular function and bad mood, reduce the incidence of falls, improve the QOF, and result in high patient satisfaction and compliance, which should be widely promoted.

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

Cited by 8 publications

References 33 publications

Long-term follow-up of patients with vestibular neuritis by caloric testing and directional preponderance calculation

Long-term follow-up of patients with vestibular neuritis by caloric testing and directional preponderance calculation

Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria

Health Promotion Combined with Psychological Care Improves Vestibular Function in Patients with Vestibular Neuritis

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