Chronic Symptoms After Vestibular Neuritis and the High-Velocity Vestibulo-Ocular Reflex. 2016

Mitesh Patel, and Qadeer Arshad, and Richard Edward Roberts, and Hena Ahmad, and Adolfo M Bronstein
*Department of Neuro-otology, Division of Brain Sciences, Imperial College London, London †School of Health, Sports and Biosciences, University of East London, London, U.K.

OBJECTIVE As the anterior and posterior semicircular canals are vital to the regulation of gaze stability, particularly during locomotion or vehicular travel, we tested whether the high-velocity vestibulo-ocular reflex (VOR) of the three ipsilesional semicircular canals elicited by the modified Head Impulse Test would correlate with subjective dizziness or vertigo scores after vestibular neuritis (VN). BACKGROUND Recovery after acute VN varies with around half reporting persistent symptoms long after the acute episode. However, an unanswered question is whether chronic symptoms are associated with impairment of the high-velocity VOR of the anterior or posterior canals. METHODS Twenty patients who had experienced an acute episode of VN at least 3 months earlier were included in this study. Participants were assessed with the video head impulse test (vHIT) of all six canals, bithermal caloric irrigation, the Dizziness Handicap Inventory (DHI), and the Vertigo Symptoms Scale short-form (VSS). RESULTS Of these 20 patients, 12 thought that they had recovered from the initial episode whereas 8 did not and reported elevated DHI and VSS scores. However, we found no correlation between DHI or VSS scores and the ipsilesional single or combined vHIT gain, vHIT gain asymmetry orcaloric paresis. The high-velocity VOR was not different between patients who thought they had recovered and patients who thought they had not. CONCLUSIONS Our findings suggest that chronic symptoms of dizziness after VN are not associated with the high-velocity VOR of the single or combined ipsilesional horizontal, anterior, or posterior semicircular canals.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012027 Reflex, Vestibulo-Ocular A reflex wherein impulses are conveyed from the cupulas of the SEMICIRCULAR CANALS and from the OTOLITHIC MEMBRANE of the SACCULE AND UTRICLE via the VESTIBULAR NUCLEI of the BRAIN STEM and the median longitudinal fasciculus to the OCULOMOTOR NERVE nuclei. It functions to maintain a stable retinal image during head rotation by generating appropriate compensatory EYE MOVEMENTS. Vestibulo-Ocular Reflex,Reflex, Vestibuloocular,Reflexes, Vestibo-Ocular,Reflexes, Vestibuloocular,Reflex, Vestibulo Ocular,Reflexes, Vestibo Ocular,Vestibo-Ocular Reflexes,Vestibulo Ocular Reflex,Vestibuloocular Reflex,Vestibuloocular Reflexes
D004244 Dizziness An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. Lightheadedness,Orthostasis,Dizzyness,Light-Headedness,Light Headedness
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults
D020338 Vestibular Neuronitis Idiopathic inflammation of the VESTIBULAR NERVE, characterized clinically by the acute or subacute onset of VERTIGO; NAUSEA; and imbalance. The COCHLEAR NERVE is typically spared and HEARING LOSS and TINNITUS do not usually occur. Symptoms usually resolve over a period of days to weeks. (Adams et al., Principles of Neurology, 6th ed, p304) Epidemic Neurolabyrinthitis,Neuritis, Vestibular,Neuronitis, Vestibular,Acute Peripheral Vestibulopathy,Acute Vestibular Neuritis,Episodic Recurrent Vertigo,Recurrent Vestibular Neuritis,Recurrent Vestibulopathy,Subacute Vestibular Neuritis,Vestibular Nerve Inflammation,Vestibular Nerve Neuritis,Vestibular Neuritis,Vestibular Neuropathy,Acute Peripheral Vestibulopathies,Acute Vestibular Neuritides,Epidemic Neurolabyrinthitides,Episodic Recurrent Vertigos,Inflammation, Vestibular Nerve,Inflammations, Vestibular Nerve,Nerve Inflammation, Vestibular,Nerve Inflammations, Vestibular,Nerve Neuritides, Vestibular,Nerve Neuritis, Vestibular,Neuritides, Acute Vestibular,Neuritides, Recurrent Vestibular,Neuritides, Subacute Vestibular,Neuritides, Vestibular,Neuritides, Vestibular Nerve,Neuritis, Acute Vestibular,Neuritis, Recurrent Vestibular,Neuritis, Subacute Vestibular,Neuritis, Vestibular Nerve,Neurolabyrinthitides, Epidemic,Neurolabyrinthitis, Epidemic,Neuronitides, Vestibular,Neuropathies, Vestibular,Neuropathy, Vestibular,Peripheral Vestibulopathies, Acute,Peripheral Vestibulopathy, Acute,Recurrent Vertigo, Episodic,Recurrent Vertigos, Episodic,Recurrent Vestibular Neuritides,Recurrent Vestibulopathies,Subacute Vestibular Neuritides,Vertigo, Episodic Recurrent,Vertigos, Episodic Recurrent,Vestibular Nerve Inflammations,Vestibular Nerve Neuritides,Vestibular Neuritides,Vestibular Neuritides, Acute,Vestibular Neuritides, Recurrent,Vestibular Neuritides, Subacute,Vestibular Neuritis, Acute,Vestibular Neuritis, Recurrent,Vestibular Neuritis, Subacute,Vestibular Neuronitides,Vestibular Neuropathies,Vestibulopathies, Acute Peripheral,Vestibulopathies, Recurrent,Vestibulopathy, Acute Peripheral,Vestibulopathy, Recurrent
D064087 Head Impulse Test Identification of SACCADES during a rapid head rotation to assess VESTIBULOOCULAR REFLEX. Head Heave Test,Head Thrust Test,Head Heave Tests,Head Impulse Tests,Head Thrust Tests,Test, Head Heave,Test, Head Impulse,Test, Head Thrust,Tests, Head Heave,Tests, Head Impulse,Tests, Head Thrust

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