Vestibular Neuritis: A Retrospective Study

Background and Aim: Vestibular neuritis is characterized by the acute onset of vertigo, with accompanying postural, oculomotor, and autonomic symptoms and signs, and usually lasts for several days. The aim of this presentation is to study patients with vestibular neuritis who were treated in the ENT Department during the last 3 years and were followed up for at least 1 year.

Material and Methods: Fifty-five patients with vestibular neuritis were included in the study. All patients underwent a complete ENT, audiological, and neuro-otologic workup, including pure tone audiometry, measurements of acoustic immittance and, in most cases, ABR. Videonystagmography recording of eye movements was performed, including saccadic, optokinetic, smooth pursuit, gaze, positional, and caloric testing. Computerized tomography or magnetic resonance imaging of the brain was also performed. All patients were treated with antivertiginous drugs during the first 3 to 4 days, and with corticosteroids in a tapered 3-week scheme. The patients had baseline evaluations and follow-up examinations after 1 and 12 months.

Results: The clinical otoneurological findings of the acute stage included spontaneous nystagmus and abnormalities of the vestibulospinal tests. The symptoms diminished gradually during the first week, and most of the patients were able to resume previous activities after 1 month. The results of electronystagmography were typical of a pure peripheral vestibular disorder. On initial examination, caloric responses of the involved ear were absent with warm and cold air irrigations. On the 12-month follow-up examination, 27 patients (49%) had normal caloric responses, 17 patients (31%) had vestibular hypesthesia, and 11 (20%) remained unresponsive. Only 5 patients did not achieve proper central compensation and presented still with vestibular symptoms.

Conclusions: The prognosis of vestibular neuritis is good. Most patients resume normal daily activities and do not complain of any vestibular symptoms, either by restoration of the activity of the involved labyrinth or by central compensation.