Vestibular neuritis affects both superior and inferior vestibular nerves

Taylor, Rachael L.; McGarvie, Leigh A.; Reid, Nicole; Young, Allison S.; Halmagyi, G. Michael; Welgampola, Miriam S.

doi:10.1212/wnl.0000000000003223

Cited by 107 publications

(128 citation statements)

References 29 publications

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“…The differences from our study could stem from our use of laser microdissection rather than "scratching" (4) and measurement of mRNA instead of DNA levels. These findings correlate with previously reported clinical observations that the involvement of the IVN is much less common than the involvement of the SVN (11)(12)(13)(14). The IVN accounts for only 1.3 to 18% of cases of vestibular neuritis (11)(12)(13)(14).…”

Section: Discussionsupporting

confidence: 91%

“…These findings correlate with previously reported clinical observations that the involvement of the IVN is much less common than the involvement of the SVN (11)(12)(13)(14). The IVN accounts for only 1.3 to 18% of cases of vestibular neuritis (11)(12)(13)(14). The rareness of the IVN may be attributed in part to diagnostic difficulties, but temporal bone pathology may also play a role (32,40).…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 95%

“…Therefore, both nerve divisions could be affected together but also independently (11,42,43). Abnormalities in the tests of inferior nerve function were significantly fewer and less extensive than those in the tests of superior nerve function (11). These contrasting results are thought to be due to anatomical differences in the path of each nerve within the temporal bone (15,40).…”

Section: Discussionmentioning

confidence: 99%

“…Vestibular neuritis of the IVN has not been as well characterized as VN of the SVN, but it is generally agreed that the SVN is much more frequently affected than the IVN. The frequency of VN reported in the available literature ranges from 40 to 48% of all cases affecting only the SVN (11-13), 34 to 56% of cases affecting both the SVN and IVN (11)(12)(13), and 1.3 to 18% of cases affecting only the IVN (11)(12)(13)(14). Possible explanations proposed previously are the longer and narrower bony canal, through which the SVN passes (15), and the double supply of the IVN in two separate bony canals (6).…”

mentioning

confidence: 97%

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Differential Involvement during Latent Herpes Simplex Virus 1 Infection of the Superior and Inferior Divisions of the Vestibular Ganglia: Implications for Vestibular Neuritis

Himmelein

Lindemann

Sinicina

et al. 2017

J Virol

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Controversy still surrounds both the etiology and pathophysiology of vestibular neuritis (VN). Especially uncertain is why the superior vestibular nerve (SVN) is more frequently affected than the inferior vestibular nerve (IVN), which is partially or totally spared. To address this question, we developed an improved method for preparing human vestibular ganglia (VG) and nerve. Subsequently, macro-and microanatomical as well as PCR studies were performed on 38 human ganglia from 38 individuals. The SVN was 2.4 mm longer than the IVN, and in 65% of the cases, the IVN ran in two separate bony canals, which was not the case for the SVN. Anastomoses between the facial and cochlear nerves were more common for the SVN (14/38 and 9/38, respectively) than for the IVN (7/38 and 2/38, respectively). Using reverse transcription-quantitative PCR (RT-qPCR), we found only a few latently herpes simplex virus 1 (HSV-1)-infected VG (18.4%). In cases of two separate neuronal fields, infected neurons were located in the superior part only. In summary, these PCR and micro-and macroanatomical studies provide possible explanations for the high frequency of SVN infection in vestibular neuritis.IMPORTANCE Vestibular neuritis is known to affect the superior part of the vestibular nerve more frequently than the inferior part. The reason for this clinical phenomenon remains unclear. Anatomical differences may play a role, or if latent HSV-1 infection is assumed, the etiology may be due to the different distribution of the infection. To shed further light on this subject, we conducted different macro-and microanatomical studies. We also assessed the presence of HSV-1 in VG and in different sections of the VG. Our findings add new information on the macro-and microanatomy of the VG as well as the pathophysiology of vestibular neuritis. We also show that latent HSV-1 infection of VG neurons is less frequent than previously reported.KEYWORDS HSV-1 latency, human, vestibular ganglia, vestibular neuritis V estibular neuritis (VN) is a common cause of an "acute unilateral vestibulopathy." The main clinical symptoms of VN are acute onset of prolonged severe spinning vertigo with spontaneous horizontal torsional nystagmus toward the unaffected ear, postural imbalance, and nausea (1). Its annual incidence is reported to be 3.5 to 15.5 per population of 100,000 (2, 3). It is the third most common cause of peripheral vestibular

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

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Differential Involvement during Latent Herpes Simplex Virus 1 Infection of the Superior and Inferior Divisions of the Vestibular Ganglia: Implications for Vestibular Neuritis

Himmelein

Lindemann

Sinicina

et al. 2017

J Virol

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The value of vestibular graviceptive pathway evaluation in the diagnosis of unilateral peripheral vestibular dysfunction

et al. 2023

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Background: Evaluation of vestibular graviceptive pathway (VGP) in patients with unilateral peripheral vestibular dysfunction (UPVD) has received increasing attention from researchers. The study aimed to investigate the value of VGP evaluation in the diagnosis of UPVD. Methods: Ninety-five UPVD patients were divided into attack and remission phase groups. VGP evaluation-related indicators, including subjective visual vertical (SVV), subjective visual horizontal (SVH), head tilt, ocular torsion (OT), and skew deviation (SD), were measured, and their correlations with cochleovestibular function test results were analyzed. The possible etiologies of contralesional VGP (c-VGP) were analyzed.Results: Positive rates of SVV, SVH, OT, and SD were significantly higher, and the degrees of SVV, SVH, and OT were significantly greater in the attack phase group than the remission phase group. The sides with abnormal VGP evaluation results were correlated with the sides with hearing loss, abnormal caloric, and video head impulse test (vHIT) results. A total of 14 patients showed c-VGP, and possible etiologies included contralateral benign paroxysmal positional vertigo (n = 4), bilateral hearing loss (n = 8), bilateral vHIT gain reduction (n = 1), autoimmune diseases (n = 6), vascular risk factors (n = 6), lacunar infarction (n = 3), and endolymphatic hydrops (n = 3). Conclusions:Alterations in SVV, SVH, OT, and SD were noted in UPVD patients in different phases, which are presumed to be related to dynamic vestibular compensation; correlations between VGP evaluation results and cochleovestibular function test results indicate that VGP evaluation may be helpful for the diagnosis of the side affected in UPVD; the presence of c-VGP may be related to bilateral labyrinth lesions or endolymphatic hydrops on the affected side; and the involvement of autoimmune mechanisms also deserves attention.

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Testing the Human Vestibulo-ocular Reflex in the Clinic: Video Head Impulses and Ocular VEMPs

Nham

McGarvie

Taylor³

et al. 2019

Contemporary Clinical Neuroscience

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Vestibular neuritis affects both superior and inferior vestibular nerves

Cited by 107 publications

References 29 publications

Differential Involvement during Latent Herpes Simplex Virus 1 Infection of the Superior and Inferior Divisions of the Vestibular Ganglia: Implications for Vestibular Neuritis

Differential Involvement during Latent Herpes Simplex Virus 1 Infection of the Superior and Inferior Divisions of the Vestibular Ganglia: Implications for Vestibular Neuritis

The value of vestibular graviceptive pathway evaluation in the diagnosis of unilateral peripheral vestibular dysfunction

Testing the Human Vestibulo-ocular Reflex in the Clinic: Video Head Impulses and Ocular VEMPs

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