Investigation of vestibular function in patients with vestibular neuritis

Kunelskaya NL, Baibakova EV, Manaenkova EA, Zaoeva ZO, Chugunova MA, Yanyushkina ES, Nikitkina YaYu. Investigation of vestibular function in patients with vestibular neuritis. Russian Bulletin of Otorhinolaryngology. 2024;89(2):4‑9. (In Russ.)
https://doi.org/10.17116/otorino2024890214

Подписка 2026 Вестник оториноларингологии (Russian Bulletin of Otorhinolaryngology)

Использование инфографики авторами научных работ

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OBJECTIVE

To optimize the diagnostic algorithm for vestibular neuritis based on an assessment of the sensitivity of clinical methods for studying vestibular function in the recovery period of the disease.

MATERIAL AND METHODS

A comprehensive assessment of the sensitivity of clinical methods for the study of vestibular function in the acute (up to 14 days: at the time of initial treatment, on the 7th and 14th day) and subacute (up to 3 months: on the 28th and 90th day) periods of the disease in 52 patients with upper vestibular neuritis was carried out.

RESULTS

The timing of the processes of restoration of vestibular function after a transferred vestibular neuritis is individual: after 14 days, restoration of vestibular function was recorded in 52% (n=27) patients, after 1 month — in 62% (n=32), after 3 months — in 71% (n=37) patients with upper vestibular neuritis. Statocoordination, statokinetic, oculomotor tests under visual control have the highest sensitivity in the acute period of vestibular neuritis, within up to 7 days from the onset of symptoms. In the subacute period of vestibular neuritis, the study of spontaneous nystagmus and nystagmus in the head shaking test retains high sensitivity only when using special tools (Frenzel goggles or videonystagmography). A decrease in the sensitivity of the head rotation test and the dynamic visual acuity test in the subacute period of vestibular neuritis is associated with the processes of central compensation and the formation of a latent saccade.

CONCLUSION

The sensitivity of clinical tests in patients with vestibular neuritis depends on the timing of the examination.

Keywords:

vestibular neuritis

video head impulse test

acute unilateral vestibulopathy

Authors:

Kunelskaya N.L.

L. I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology;
Pirogov Russian National Research Medical University

ORCID: 0000-0002-1001-2609

Baibakova E.V.

Sverzevsky Research Institute of Otorhinolaryngology

SPIN RSCI: 8699-2693
Scopus AuthorID: 55806423300
ResearcherID: C-4192-2014
ORCID: 0000-0002-3430-6273

Manaenkova E.A.

Sverzhevky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0001-8023-4883

Zaoeva Z.O.

Sverzhevky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0002-2501-0200

Chugunova M.A.

Sverzhevky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0002-4632-7901

Yanyushkina E.S.

Sverzhevsky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0002-6199-1173

Nikitkina Ya.Yu.

Sverzhevsky Research Clinical Institute of Otorhinolaryngology

ORCID: 0000-0003-1180-3661

Received:

30.11.2023

Accepted:

09.02.2024

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References:

Pal’chun VT, Makoeva AA, Guseva AL. Dizziness and vertigo associated with vestibular neuronitis: the approaches to the diagnostics and treatment. Vestnik otorinolaringologii. 2018;83(3):4-10. (In Russ.). https://doi.org/10.17116/otorino20188334
Ruttin E. Zur Differentialdiagnose der Labyrinth — und Hörnerverkrankungen. Zeitschrift-fur-Ohrenheilkunde. 1909;57;327-333.
Arbusow V, Derfuss T, Held K, Himmelein S, Strupp M, Gurkov R, Brandt T, Theil D. Latency of herpes simplex virus type-1 in human geniculate and vestibular ganglia is associated with infiltration of CD8+ T cells. Journal of Medical Virology. 2010;82(11): 1917-1920. https://doi.org/10.1002/jmv.21904
Strupp M, Bisdorff A, Furman J, Hornibrook J, Jahn K, Maire R, Newman-Toker D, Magnusson M. Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria. Journal of Vestibular Research: Equilibrium and Orientation. 2022;32(5): 389-406. PMID: 35723133; PMCID: PMC9661346. https://doi.org/10.3233/VES-220201
Kleffner I, Dörr J, Ringelstein M, Gross CC, Böckenfeld Y, Schwindt W, Sundermann B, Lohmann H, Wersching H, Promesberger J, von Königsmarck N, Alex A, Guthoff R, Frijns CJ, Kappelle LJ, Jarius S, Wildemann B, Aktas O, Paul F, Wiendl H, Duning T; European Susac Consortium (EuSaC). Diagnostic criteria for Susac syndrome. Journal of Neurology, Neurosurgery, and Psychiatry. 2016;87(12):1287-1295. https://doi.org/10.1136/jnnp-2016-314295
Zamergrad MV, Kunelskaya NL, Guseva AL, Amelin AV, Lilenko SV, Samartcev IN, Zaytseva OV, Melnikov OA, Voronov VA, Lyapin AV. Betahistine in vestibular disorders: current concepts and perspectives. Vestnik otorinolaringologii. 2021;86(2):73-81. (In Russ.). https://doi.org/10.17116/otorino20218602173
Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009;40(11):3504-3510. PMID: 19762709; PMCID: PMC4593511. https://doi.org/10.1161/strokeaha
Zamergrad MV, Parfenov VA, Morozova SV, Mel’nikov OA, Antonenko LM. The peripheral vestibular disorders encountered in the routine out-patient practical work. Vestnik otorinolaringologii. 2017;82(1):30-33. (In Russ.). https://doi.org/10.17116/otorino201782130-33
Rumyantsev PO, Saenko VA, Rumyantseva UV, Chekin SYu. Statistical methods for the analyses in clinical practice. Part 2. Survival analysis and multivariate statistics. Problemy endokrinologii. 2009;55(6):48-56. (In Russ.). https://doi.org/10.14341/probl200955648-56
McGarvie LA, MacDougall HG, Halmagyi GM, Burgess AM, Weber KP, Curthoys IS. The Video Head Impulse Test (vHIT) of Semicircular Canal Function-Age-Dependent Normative Values of VOR Gain in Healthy Subjects. Frontiers in Neurology. 2015;6:154. https://doi.org/10.3389/fneur.2015.00154
Cerchiai N, Navari E, Sellari-Franceschini S, Re C, Casani AP. Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades. Otolaryngology — Head and Neck Surgery. 2018;158(3):527-533. https://doi.org/10.1177/0194599817740327
Kim S, Jung YK, Kim MJ, Kim K-S, Kim HJ. Diagnostic evolution of vestibular neuritis after long-term monitoring. Brazilian Journal of Otorhinolaryngology. 2022;88(Suppl 1):S14-S17. Epub 2021 Mar 5. PMID: 33722519; PMCID: PMC9734252. https://doi.org/10.1016/j.bjorl.2021.02.004
Taylor RL, McGarvie LA, Reid N, Young AS, Halmagyi GM, Welgampola MS. Vestibular neuritis affects both superior and inferior vestibular nerves. Neurology. 2016;87(16):1704-1712. https://doi.org/10.1212/WNL.0000000000003223
Büki B, Hanschek M, Jünger H. Vestibular neuritis: Involvement and long-term recovery of individual semicircular canals. Auris Nasus Larynx. 2017;44(3):288-293. https://doi.org/10.1016/j.anl.2016.07.020
Kunelskaya NL, Baybakova EV, Guseva AL, Nikitkina YaYu, Chugunova MA, Manaenkova EA. The compensation of the vestibulo-ocular reflex during rehabilitation of the patients presenting with vestibular neuritis. Vestnik otorinolaringologii. 2018;83(1):27-31. (In Russ.). https://doi.org/10.17116/otorino201883127-31
Arshad Q, Cousins S, Golding JF, Bronstein AM. Factors influencing clinical outcome in vestibular neuritis — A focussed review and reanalysis of prospective data. Journal of Neurological Sciences. 2023;446:120579. https://doi.org/10.1016/j.jns.2023.120579