Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo

Martín-Sanz, Eduardo; Rueda, Almudena; Estéban-Sánchez, Jonathan; Yanes, Joaquin; Rey-Martínez, Jorge; Ricardo, Sanz Fernandez

doi:10.1097/mao.0000000000001468

Cited by 29 publications

(20 citation statements)

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“…A three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (MRI) study revealed that the pre-contrast hyperintense signal in the cochlea, vestibule, and the vestibulocochlear nerve of RHS patients was correlated with presence of dizziness [ 10 ]. In addition, the different aspects of vestibular impairment and recovery were compared between RHS and other inner ear diseases such as vestibular neuritis (VN) or sudden deafness with vertigo [ 11 , 12 ]. In contrast, the characteristics of dizziness in BP have rarely been studied.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

et al. 2018

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Background and ObjectivesWe aimed to assess the clinical significance of dizziness associated with acute peripheral facial palsy (APFP).Subjects and MethodsMedical records of patients who visited an otorhinolaryngology clinic at a university hospital and were admitted for treatment of APFP between 2014 and 2016 were thoroughly reviewed.ResultsIn total, 15.3% (n=15) of patients had dizziness. Continuous, rotatory dizziness without exacerbating factors was most common and frequently accompanied by nausea/vomiting. Dizziness disappeared within 1 week during the hospitalization period. Patients with Ramsay Hunt syndrome (31.0%) had dizziness more frequently than those with Bell’s palsy (8.7%). In addition, higher hearing thresholds and pain around the ear was reported more often in dizzy patients (p<0.05). Logistic regression analysis revealed that the initial House-Brackmann grade of facial paralysis was solely associated with final recovery, but dizziness was not associated with prognosis.ConclusionsPatients with APFP may have transient dizziness in the early stage, which may be more frequently accompanied by worse hearing thresholds and/or pain around the ear. However, these symptoms including dizziness seem to be unrelated to final prognosis.

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Section: Introductionmentioning

confidence: 99%

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

et al. 2018

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“…Although the cause underlying the latency differences of the (compensatory and anticompensatory) corrective saccades in the latency periods between the HIMP and SHIMP procedures has not been well established, recent studies have reported that the refixation saccade latencies are in relation with the time evolution of the vestibular dysfunction in both procedures ( 5 , 7 ). We hypothesized that some central mechanisms such as the head impulse prediction could be one of the causes behind the observed differences in the saccadic eye responses for the SHIMP paradigm.…”

Section: Introductionmentioning

confidence: 99%

The Role of Predictability in Saccadic Eye Responses in the Suppression Head Impulse Test of Horizontal Semicircular Canal Function

et al. 2017

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BackgroundIn the suppression head impulse paradigm (SHIMP) vHIT protocol, the participant is instructed to follow with his gaze a mobile target generated by a laser placed on the participant’s head. Recent studies have reported that the refixation saccade latencies are in relation with the time evolution of the vestibular dysfunction in both (standard and SHIMP) procedures. We hypothesized that some central mechanisms like head impulse prediction could be one of the causes for the differences in the saccadic eye responses.MethodsA prospective cohort non-randomized study was designed. For the SHIMP protocol, recorded with the ICS Impulse ver. 4.0® (Otometrics A/S, Taastrup, Denmark) vHIT device, three different algorithms were performed: “predictable,” “less predictable,” and “unpredictable” depending on the target’s predictability. A mathematical method was developed to analyze the SHIMP responses. The method was implemented as an additional tool to the MATLAB open source script for the extended analysis of the vHIT responses named HITCal.ResultsIn cohort 1, 52 participants were included in “predictable” SHIMP protocol. In cohort 2, 60 patients were included for the “less predictable” and 35 patients for the “unpredictable” SHIMP protocol. The participants made more early saccades when instructed to perform the “predictable” paradigm compared with the “less predictable” paradigm (p < 0.001). The less predictable protocol did not reveal any significant difference when compared with the unpredictable protocol (p = 0.189). For the latency of the first saccade, there was statistical difference between the “unpredictable” and “predictable” protocols (p < 0.001) and between the “less predictable” and “predictable” protocols (p < 0.001). Finally, we did not find any relationship between the horizontal vestibulo-ocular reflex (hVOR) gain and the latency of the saccades.ConclusionWe developed a specific method to analyze and detect early SHIMP saccades. Our findings offer evidence regarding the influence of predictability on the latency of the SHIMP saccadic responses, suggesting that early saccades are probably caused by a conditioned response of the participant. The lack of relationship between the hVOR gain and the latency of the saccades suggests that the predictive behavior that caused the early eye saccades are independent of the vestibular function.

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“…In the clinical course of VN, the normalization rate of the caloric test is known to be 40-66% after 6 months to 1 year. 17,23,32,34,38,39) In the case of vHIT, the normalization rate was reported to be higher than that of the caloric test. 17) In other studies, the normalization rate of the lateral canal gain in the lesion was 38-52% at 1 month after onset and 79-87% at 6 months after onset using vHIT.…”

Section: Clinical Course and Follow-upmentioning

confidence: 95%

“…3,21,22) In a study evaluating the recovery of vestibular function in patients with Ramsay-Hunt syndrome with vertigo and those with VN using vHIT, patients with VN recovered significantly faster than those with Ramsay-Hunt syndrome. 23)…”

Section: Differential Diagnosismentioning

confidence: 99%

Clinical Application of Video Head Impulse Test in Acute Vestibular Syndrome

Yoo¹

2020

Korean J Otorhinolaryngol-Head Neck Surg

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Acute unilateral vestibulopathy (AUV) is the recommended term [rather than the more widely used 'vestibular neuritis (VN)'] for all pathologies involving sudden impairment of the unilateral peripheral vestibular function regardless of the exact location of the lesion. Acute vestibular syndrome (AVS) is an upper-level entity of AUV, which is the most common cause of AVS, and includes acute central vertigo. AVS typically presents with the symptoms of new onset continuous vertigo, gait instability, and nausea/vomiting lasting several days to weeks. The video head impulse test (vHIT) was recently developed and has been widely adopted at clinics and emergency centers. In this study, we will review the differential diagnosis of AVS using vHIT. In addition, we will describe the subtypes of VN and the use of vHIT for follow-up testing in AVS.

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Vestibular Restoration and Adaptation in Vestibular Neuritis and Ramsay Hunt Syndrome With Vertigo

Abstract: In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.

Cited by 29 publications

References 25 publications

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy

The Role of Predictability in Saccadic Eye Responses in the Suppression Head Impulse Test of Horizontal Semicircular Canal Function

Clinical Application of Video Head Impulse Test in Acute Vestibular Syndrome

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