Current diagnosis and treatment of vestibular neuritis: a narrative review

Bae, Chang Hoon; Na, Hyung Gyun; Choi, Yoon Seok

doi:10.12701/yujm.2021.01228

Cited by 19 publications

(15 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is thought to be related to a prior or concurrent viral infection and the symptoms normally take weeks to months to resolve. It is worth mentioning that vestibular neuritis is not a life-threatening condition, identifying it through other conditions such as strokes is critical [17]. To differentiate vestibular neuritis from other central causes like central vertigo, BPPV, VM, psychogenic vertigo, MD, cervical vertigo, psychogenic vertigo, and chronic dizziness, an experienced physician is required to take detailed information about the patient's history and conduct an appropriate clinical examination [17].…”

Section: Vestibular Neuritismentioning

confidence: 99%

A Holistic Approach to a Dizzy Patient: A Practical Update

Koukoulithras¹,

Drousia²,

Kolokotsios³

et al. 2022

Cureus

View full text Add to dashboard Cite

Dizziness is one of the most common symptoms encountered by physicians daily. It is divided into four categories: vertigo, disequilibrium, presyncope, and psychogenic dizziness. It is essential to distinguish these four symptoms because the causes, prognosis, and treatment differ. Vertigo constitutes a disease of the central or peripheral nervous system. Central origin vertigo may be a life-threatening situation and must be detected as soon as possible because it includes diseases such as stroke, hemorrhage, tumors, and multiple sclerosis. Peripheral origin vertigo includes benign diseases, which may be fully treatable such as vestibular migraine, benign paroxysmal positional vertigo, vestibular neuritis, Ménière's disease, and cervical vertigo. The HINTS (head impulse, nystagmus, test of skew) examination is essential to distinguish central from peripheral causes. A detailed history including the duration of vertigo (episodic or continuous), its trigger, and a clinical examination step by step following the appropriate protocol could help to make a definite and accurate diagnosis and treatment. Due to a lack of expertise in dizziness and inappropriate treatment, many patients are admitted to dizziness clinics with long-standing dizziness. A holistic treatment combining medications, vestibular rehabilitation, physiotherapy, and psychotherapy should be initiated to improve the quality of life of these patients. So, this review aims to recommend a clinical protocol for approaching a dizzy patient with vertigo and to present in detail the epidemiology, pathophysiology, symptoms, diagnosis, and contemporary treatments of all causes of vertigo.

show abstract

Section: Vestibular Neuritismentioning

confidence: 99%

A Holistic Approach to a Dizzy Patient: A Practical Update

Koukoulithras¹,

Drousia²,

Kolokotsios³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Antiemetics, antihistamines, anticholinergics, benzodiazepines, and corticosteroids (controversial) are used for treatment. Vestibular rehabilitation exercises are effective in reducing the duration of symptoms and improving gaze stability and vestibulospinal compensation; a home-based or formal rehabilitation program should be prescribed after the acute symptoms have subsided (Bae et al 2022 ; Jeong et al 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Acute vestibular neuritis: A rare complication after the adenoviral vector-based COVID-19 vaccine

et al. 2022

View full text Add to dashboard Cite

Vestibular neuritis was first reported in 1952 by Dix and Hallpike, and 30% of patients reporting a flu-like symptom before acquiring the disorder. The most common causes are viral infections, often resulting from systemic viral infections or bacterial labyrinthitis. Here we presented a rare case of acute vestibular neuritis after the adenoviral vector-based COVID-19 vaccination. A 51-year-old male pilot awoke early in the morning with severe vertigo, nausea, and vomiting after receiving the first dose of the ChAdOx1 nCoV-19 vaccine 11 days ago. Nasopharyngeal SARS-CoV-2 RT-PCR test and chest CT scan were inconclusive for COVID-19 pneumonia. Significant findings were a severe spontaneous and constant true-whirling vertigo which worsened with head movement, horizontal-torsional spontaneous nystagmus, abnormal caloric test, positive bedside head impulse tests, and inability to tolerate head-thrust test. PTA, MRI of the brain and internal auditory canal, and cerebral CT arteriography were normal. According to the clinical, imaging, and laboratory findings, he was admitted to the neurology ward and received treatment for vestibular neuritis. His vertigo increased gradually over 6–8 h, peaking on the first day, and gradually subsided over 7 days. Ten days later, the symptoms became tolerable; the patient was discharged with advice for home-based vestibular rehabilitation exercises. Despite the proper treatment and rehabilitation, signs of dynamic vestibular imbalances persisted after 1 year. Based on the Federal Aviation Administration (FAA) regulations, the Air Medical Council (AMC) suspended him from flight duties until receiving full recovery. Several cases of vestibular neuritis have been reported in the COVID-19 patients and after the COVID-19 vaccination. This is the first case report of acute vestibular neuritis after the ChAdOx1 nCoV-19 vaccination in a healthy pilot without past medical history. However, the authors believe that this is a primary clinical suspicion that must be considered and confirmed after complete investigations.

show abstract

“…Acute unilateral vestibulopathy (AUVP), also known as vestibular neuritis, is an acute peripheral vestibular syndrome characterized by acute unilateral loss of peripheral vestibular function without sensitive central nervous system or acute audiological symptoms or signs ( 1 ). It is the third most common peripheral vestibular disease after benign paroxysmal positional vertigo (BPPV) and Meniere's disease ( 2 ). There were no unified diagnostic criteria for AUVP, so there is no compelling new epidemiological study ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…It is reported that the annual incidence rate of AUVP is 3.5–15.5 per 100,000 people ( 1 , 4 ), the recurrence rate is 1.9% ( 6 )−10.7% ( 7 ), and approximately 4–9.8% of adult patients and 3.3% of children are treated for acute unilateral vestibular loss ( 8 ). Although it is thought to be caused by viral inflammation or potential viral reactivation in vestibular nerve ganglia, the exact cause of vestibular neuritis is unclear ( 2 ). Therefore, the treatment methods for AUVP are various, such as corticosteroids, antiviral drugs, and vestibular rehabilitation training ( 2 ), but the treatment effects were not satisfactory.…”

Section: Introductionmentioning

confidence: 99%

“…Although it is thought to be caused by viral inflammation or potential viral reactivation in vestibular nerve ganglia, the exact cause of vestibular neuritis is unclear ( 2 ). Therefore, the treatment methods for AUVP are various, such as corticosteroids, antiviral drugs, and vestibular rehabilitation training ( 2 ), but the treatment effects were not satisfactory.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Identification of hub genes and pathophysiological mechanism related to acute unilateral vestibulopathy by integrated bioinformatics analysis

Cheng

Zheng²,

Yu³

et al. 2022

Front. Neurol.

View full text Add to dashboard Cite

BackgroundAlthough many pathological mechanisms and etiological hypotheses of acute unilateral vestibulopathy (AUVP) have been reported, but the actual etiology remains to be elucidated.ObjectiveThis study was based on comprehensive bioinformatics to identify the critical genes of AUVP and explore its pathological mechanism.MethodsGene expression profiles of AUVP and normal samples were collected from GSE146230 datasets of the Gene Expression Omnibus (GEO) database. Weighted gene co-expression network analysis (WGCNA) was constructed, and the WGCNA R-package extracted significant modules. The limma R-package was applied to identify differentially expressed genes (DEGs). The common genes of practical modules and DEGs were screened for GO and KEGG pathways analysis. The protein–protein interaction (PPI) layout and hub genes validation was created by Cytoscape software using the link from the STRING database. The functions of hub genes were predicted through the CTD (comparative genetics database).ResultsA total of 332 common genes were screened from practical modules and DEGs. Functional enrichment analysis revealed that these genes were predominantly associated with inflammation and infection. After construction of PPI, expressions of hub genes, and drawing ROC curves, LILRB2, FPR1, AQP9, and LILRA1 are highly expressed in AUVP (p < 0.05) and have a certain diagnostic efficacy for AUVP (AUC > 0.7), so they were selected as hub genes. The functions of hub genes suggested that the occurrence of AUVP may be related to inflammation, necrosis, hepatomegaly, and other conditions in CTD.ConclusionLILRB2, FPR1, AQP9, and LILRA1 may play essential roles in developing AUVP, providing new ideas for diagnosing and treating AUVP.

show abstract

Current diagnosis and treatment of vestibular neuritis: a narrative review

Cited by 19 publications

References 48 publications

A Holistic Approach to a Dizzy Patient: A Practical Update

A Holistic Approach to a Dizzy Patient: A Practical Update

Acute vestibular neuritis: A rare complication after the adenoviral vector-based COVID-19 vaccine

Identification of hub genes and pathophysiological mechanism related to acute unilateral vestibulopathy by integrated bioinformatics analysis

Contact Info

Product

Resources

About