Vestibular Neuritis � A Horizontal Semicircular Canal Paresis?

Büchele, W; Brandt, Thomas

doi:10.1159/000416097

Cited by 41 publications

(21 citation statements)

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“…Vestibular neuritis is not functionally equivalent to a total vestibular deficit. This was suspected since vestibular neuritis and benign paroxysmal positional vertigo (BPPV) can occur in the same ear (16). A later three-dimensional analysis of canal function made confirmation possible (17).…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…Benign paroxysmal positional vertigo occurs relatively often in patients who have had VN (about 12%) [Büchele and Brandt, 1988]; it may also be induced by viral labyrinthitis. Inflammation of the labyrinth could lead to a loosening of otoconia, which enter the SCCs causing canalolithiasis and subsequently benign paroxysmal positional vertigo.…”

Section: Discussionmentioning

confidence: 99%

HSV-1 Not Only in Human Vestibular Ganglia but Also in the Vestibular Labyrinth

et al. 2001

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Reactivation of herpes simplex virus type 1 (HSV-1) in the vestibular ganglion (VG) is the suspected cause of vestibular neuritis (VN). Recent studies reported the presence of HSV-1 DNA not only in human VGs but also in vestibular nuclei, a finding that indicates the possibility of viral migration to the human vestibular labyrinth. Distribution of HSV-1 DNA was determined in geniculate ganglia, VGs, semicircular canals, and macula organs of 21 randomly obtained human temporal bones by nested PCR. Viral DNA was detected in 48% of the labyrinths, 62% of the VGs, and 57% of the geniculate ganglia. The potential significance of this finding is twofold: (1) Inflammation in VN could also involve the labyrinth and thereby cause acute unilateral vestibular deafferentation. (2) As benign paroxysmal positional vertigo often occurs in patients who have had VN, it could also be a sequel of viral labyrinthitis.

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“…asymmetric function indicates a (unilateral) vestibular lesion. Both innervation and blood supply divide the labyrinth into two parts (for review: Büchele & Brandt, 1988;Oas & Baloh, 1992). The posterior semicircular canal and the majority of the sacculus are innervated by the inferior vestibular nerve and they receive their blood supply from the posterior vestibular artery.…”

Section: Introductionmentioning

confidence: 99%

Symmetry measures of vestibular evoked myogenic potentials using objective detection criteria

Brantberg¹,

Fransson²

2001

Scandinavian Audiology

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Vestibular evoked myogenic potentials (VEMP) has been put forward as a test to evaluate the symmetry of saccular function. In the present study, the symmetry of VEMP was evaluated in 23 healthy subjects using automatic analysis. In response to binaural clicks with a stimulus repetition rate of 4/s all subjects revealed significant VEMP on both sides. The ipsilateral response to monaural clicks was similar to the response to binaural clicks. Although there were large interindividual variations in amplitude, there were only small variations in latency. VEMP measurements were also assessed using different stimulus rates. At the higher stimulus rates there was a decrease in the VEMP amplitude but there were only small changes in the latency. These findings might suggest that amplitude measures are more likely than latency measures to reveal small vestibular lesions.

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Vestibular Neuritis � A Horizontal Semicircular Canal Paresis?

Cited by 41 publications

References 0 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

HSV-1 Not Only in Human Vestibular Ganglia but Also in the Vestibular Labyrinth

Symmetry measures of vestibular evoked myogenic potentials using objective detection criteria

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