• Title/Summary/Keyword: Vestibular neuritis

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Current diagnosis and treatment of vestibular neuritis: a narrative review

  • Ba, Chang Hoon;Na, Hyung Gyun;Choi, Yoon Seok
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.81-88
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    • 2022
  • Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

A Case Report of Korean Medicine Treatment Including Samchulgunbi-tang-gagambang in a Patient with Vestibular Neuritis (비위허약으로 변증된 전정신경염 환자의 삼출건비탕가감방을 포함한 한의 치료 치험 1례)

  • Ye-seul Park;Jeong-hui Kim;Ju-yeon Song;Ho-ryong Yoo;In-chan Seol;Yoon-sik Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.4
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    • pp.757-764
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    • 2023
  • Background: Vestibular neuritis is a common cause of acute unilateral peripheral vestibulopathy. Vestibular neuritis is the second most common disease among patients with dizziness. Clinical symptoms of vestibular neuritis include the sudden onset of vertigo with spontaneous nystagmus, unsteady gait, nausea, and vomiting that last from days to weeks. However, even after the vertigo disappears, difficulty maintaining balance while walking may persist for weeks to months. Antihistamines, serotonin receptor blockers, and benzodiazepine vestibular suppressants are widely used as symptomatic treatments to reduce the severity of symptoms that occur in the acute phase. Case Summary: A patient diagnosed with acute vestibular neuritis was treated with acupuncture, moxibustion, and herbal medicine. We used the visual analog scale (VAS) to assess each symptom and the vertigo score to observe the effect of treatment. After treatment, the VAS scores for each symptom and the vertigo score decreased, and the severity of nystagmus was reduced. Conclusion: This study suggests that Korean medicine treatments, including Samchulgunbi-tang-gagam, could be effective in improving the clinical symptoms of vestibular neuritis.

A Clinical Review of Peripheral Dizziness Patient-one case (末梢性 眩暈을 主症狀으로 入院한 患者 1例에 對한 症例報告)

  • Jeong Hyun-a;Yeon Kyung-jin;Roh Seok-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.17 no.2
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    • pp.146-152
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    • 2004
  • Introduction: Vertigo is one of the common symptoms that we can see often clinically. It is hallucination to motion of oneself or surroundings. Vertigo include not only simple whirling sensation but also leaning or falling down sensation. Particularly in vestibular neuritis, the principal symptoms is dizziness and accompanied by nystagmus, gait imbalance, nausea, vomiting. Cause of vestibular neuritis is inflammatory disease such as common cold. Objective: The aim of this study was to estimate the efficacy of oriental-treatment on vestibular neuritis patient Subjects: We diagnosed one patient who had severe vertigo and gait imbalance as "dizziness retention of phlegm"(담훈) and treat orientally. Conclusion: After oriental-treatment for 15 days, walk balance was improved and no more vertigo was appeared. We could assume that in the vertigo and gait inbalance due to vestibular neuritis, the acupuncture and herbal medicine can be used.

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Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Journal of Audiology & Otology
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    • v.25 no.2
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    • pp.89-97
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    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Korean Journal of Audiology
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    • v.25 no.2
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    • pp.89-97
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    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

Case of Combined Eastern-Western Medicine Treatment on a Patient Diagnosed with Benign Paroxysmal Positional Vertigo after Acute Vestibular Neuritis (양성 돌발성 체위 현훈으로 이행된 급성 전정신경염 환자의 한양방 협진 치료 1례)

  • Park, Young-hwa;Lim, Bo-ra;Ok, Hyo-joon;Sun, Jong-joo;Park, Joon-ha
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.273-282
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    • 2016
  • Objective: This clinical study was performed with a female patient to evaluate the effects of combined Eastern-Western medicine treatment on benign paroxysmal positional vertigo after acute vestibular neuritis.Method: We used acupuncture, herbal medication, Western medication, fluid therapy, and the canalith repositioning maneuver to treat a female patient suffering from dizzy spells. The vertigo scale was checked to assess any improvement in symptoms.Results: The patient had originally recovered from acute vestibular neuritis, but after the first discharge, she came down with benign paroxysmal positional vertigo and had to be rehospitalized. She eventually got better, however, and her score on the vertigo scale improved.Conclusion: This study demonstrates that combined Eastern-Western medicine treatment may be an effective option for treating benign paroxysmal positional vertigo after acute vestibular neuritis, despite the difficulty of the treatment in this case.

A Case of Isolated Nodular Infarction Mimicking Vestibular Neuritis on the Contralateral Side

  • Lee, Jun;Song, Kudamo;Yu, In Kyu;Lee, Ho Yun
    • Korean Journal of Audiology
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    • v.23 no.3
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    • pp.167-172
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    • 2019
  • Differentiating central vestibulopathy from more common vestibular disorders is crucial because it often necessitates different treatment strategies, and early detection can help to minimize potential complications. Isolated nodular infarct is one of the central brain lesions that can mimic peripheral vertigo. We present a case of isolated nodular infarct that had been misdiagnosed as vestibular neuritis on the contralateral side at the initial evaluation. The patient was successfully treated with anticoagulants and antihyperlipidemic agents. Clinicians should keep in mind that some causes of central vertigo mimic peripheral vestibulopathy at the early stage.

A Case of Isolated Nodular Infarction Mimicking Vestibular Neuritis on the Contralateral Side

  • Lee, Jun;Song, Kudamo;Yu, In Kyu;Lee, Ho Yun
    • Journal of Audiology & Otology
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    • v.23 no.3
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    • pp.167-172
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    • 2019
  • Differentiating central vestibulopathy from more common vestibular disorders is crucial because it often necessitates different treatment strategies, and early detection can help to minimize potential complications. Isolated nodular infarct is one of the central brain lesions that can mimic peripheral vertigo. We present a case of isolated nodular infarct that had been misdiagnosed as vestibular neuritis on the contralateral side at the initial evaluation. The patient was successfully treated with anticoagulants and antihyperlipidemic agents. Clinicians should keep in mind that some causes of central vertigo mimic peripheral vestibulopathy at the early stage.

Differential diagnosis of vertigo (어지럼증의 감별진단)

  • Kang, Ji-Hoon;Shin, Ji-Yong;Kim, Min-Ju;Ma, Hyeo-Il
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.64-75
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    • 2019
  • Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.

Vestibular Histopathology in Temporal Bone (전정질환의 측두골 조직병리)

  • Nam, Sung Il
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.130-133
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    • 2018
  • There are a number of reports on the pathologies of vestibular disorders. However, these studies included only a few examples, which were not quantitative but merely anecdotal or descriptive. However, a single tissue section may be relevant to a specific disease in multiple ways. The histopathological characteristics of common peripheral vestibulopathies, including benign paroxysmal positional vertigo, $M{\acute{e}}ni{\grave{e}}re^{\prime}s$ syndrome, labyrinthitis, vestibular neuritis, and ototoxicity, have been described. A recent study validated a new quantitative method for determining vestibular otopathology. Detailed quantitative analyses of vestibular pathology are required to obtain a deeper understanding of the vestibular system. Such studies will likely reveal the pathophysiological causes of specific diseases by elucidating the correlations between structural and functional features. Therefore, histopathological studies of vestibular disorders should be performed.