Journal of Yeungnam Medical Science

Review article

Current diagnosis and treatment of vestibular neuritis: a narrative review: Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi; J Yeungnam Med Sci. 2022;39(2):81-88. Published online August 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01228

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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.

Citations

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Zhaohui Song, Yuchuan Ding, Nathan Sim, Ho Jun Yun, Jing Feng, Pan Gu, Xiaokun Geng
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Clayton Siminski, John C Benson, Matthew L Carlson, John I Lane
The Neuroradiology Journal.2024;[Epub] CrossRef
Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus
N.L. Kunelskay, G.E. Ivanova, E.V. Baybakova, A.L. Guseva, V.A. Parfenov, M.V. Zamergrad, O.V. Zaitseva, O.A. Melnikov, A.A. Shmonin, M.N. Maltseva
Vestnik otorinolaringologii.2024; 89(1): 52. CrossRef
Vertigo in the Setting of COVID-19 Infection: A Case Report
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Cureus.2023;[Epub] CrossRef
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Symptom of vertigo and dizziness in patients with COVID-19
E. V. Isakova
Russian neurological journal.2023; 28(4): 5. CrossRef
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Geraskina M.M., Razzhivina K.S., Ustinov S.A.
"Medical & pharmaceutical journal "Pulse".2023; : 30. CrossRef
Acute vestibular neuritis: A rare complication after the adenoviral vector-based COVID-19 vaccine
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Ioannis Koukoulithras, Gianna Drousia, Spyridon Kolokotsios, Minas Plexousakis, Alexandra Stamouli, Charis Roussos, Eleana Xanthi
Cureus.2022;[Epub] CrossRef
Identification of hub genes and pathophysiological mechanism related to acute unilateral vestibulopathy by integrated bioinformatics analysis
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Case report

Isolated hemorrhage in the cerebellar vermis with vertigo and body lateropulsion to the contralesional side: Dong Hyun Lee, Se-Jin Lee; Yeungnam Univ J Med. 2019;36(3):269-272. Published online September 9, 2019; DOI: https://doi.org/10.12701/yujm.2019.00318

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Abstract PDF: There have been several reports of patients with isolated lesions of the cerebellar vermis presenting with clinical features similar to those of peripheral vestibulopathy. We report a case of small, isolated hematoma in the cerebellar vermis in a patient who presented with vertigo, ipsilesional nystagmus, and body lateropulsion to the contralesional side without the usual signs or symptoms of cerebellar dysfunction. Although they present with symptoms that mimic those of peripheral vestibulopathy, and brain computed tomography shows no abnormality, as there may be a small, isolated hematoma or infarction in the cerebellar vermis. Thus, brain magnetic resonance imaging should be performed in elderly patients with vascular risk factors.

Original Article

Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography: Yoon Seok Choi, Hyung Gyun Na, Si Youn Song, Yong Dae Kim, Chang Hoon Bae; Yeungnam Univ J Med. 2017;34(1):29-36. Published online June 30, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.1.29

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Abstract PDF

BACKGROUND
Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. METHODS: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. RESULTS: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. CONCLUSION: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

Citations

Citations to this article as recorded by

Current diagnosis and treatment of vestibular neuritis: a narrative review
Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi
Journal of Yeungnam Medical Science.2022; 39(2): 81. CrossRef
Dizziness in Patients With Obstructive Sleep Apnea
Jae Rim Kim, Soo Ryun Park, Hea Ree Park, Eun Yeon Joo
Journal of Sleep Medicine.2022; 19(2): 39. CrossRef

Review

Differential diagnosis of peripheral vertigo.: Chang Hoon Bae; Yeungnam Univ J Med. 2014;31(1):1-8. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.1

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Abstract PDF

Dizziness can be classified mainly into 4 types: vertigo, disequilibrium, presyncope, and lightheadedness. Among these types, vertigo is a sensation of movement or motion due to various causes. The main causes of peripheral vertigo are benign paroxysmal positional vertigo (BPPV), acute vestibular neuritis (AVN), and Meniere's disease. BPPV is one of the most common causes of peripheral vertigo. It is characterized by brief episodes of mild to intense vertigo, which are triggered by specific changes in the position of the head. BPPV is diagnosed from the characteristic symptoms and by observing the nystagmus such as in the Dix-Hallpike test. BPPV is treated with several canalith repositioning procedures. AVN is the second most common cause of peripheral vertigo. Its key symptom is the acute onset of sustained rotatory vertigo without hearing loss. It is treated with symptomatic therapy with antihistamines, anticholinergic agents, antidopaminergic agents, and gamma-aminobutyric acid-enhancing agents that are used for symptoms of acute vertigo. Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, and tinnitus. It is traditionally relieved with life-style modification, a low-salt diet, and prescription of diuretics. However, diagnosis and treatment of the peripheral vertigo can be difficult without knowledge of BPPV, AVN, and Meniere's disease. This article provides information on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere's disease.

Citations

Citations to this article as recorded by

The Effect of Banhabaekchulcheonma-tang on Benign Paroxysmal Positional Vertigo: A Systematic Review Using the CNKI Database
Gi-hyeon Gwon, Seo-hye Oh, Eun-soo Park, Mi-hyeon Kim, Seung-hyo Hong, Geum-ju Song, Eun-young Park
The Journal of Internal Korean Medicine.2021; 42(4): 572. CrossRef
Korean Medicine Interventions for Benign Paroxysmal Positional Vertigo: A Systematic Review of Clinical Studies Published in Korea
Jun-su Jung, Sung-heon Jung, Min-joo Kim, Jang-kyung Park, Kwang-ho Bae, Kyung-hwan Kong, Ho-yeon Ko
The Journal of Internal Korean Medicine.2017; 38(4): 479. CrossRef
Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography
Yoon Seok Choi, Hyung Gyun Na, Si Youn Song, Yong Dae Kim, Chang Hoon Bae
Yeungnam University Journal of Medicine.2017; 34(1): 29. CrossRef

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