Multifrequency testing of patients after acute isolated vestibular deficit
Authors:
Kateryna Kozynkina-Marchenko
Authors‘ workplace:
Otorinolaryngologické oddělení, Orlickoústecká nemocnice
Published in:
Otorinolaryngol Foniatr, 73, 2024, No. 2, pp. 71-80.
Category:
Original Article
doi:
https://doi.org/10.48095/ccorl202471
Overview
Introduction: Acute unilateral vestibulopathy (AUVP) is defined as an acute peripheral vestibular syndrome without evidence of central neurological or audiological symptoms. Currently, there is no uniform instrumental testing protocol for the diagnosis and follow-up of patients with AUVP. Vestibular tests provide information in different frequency bands of the vestibuloocular reflex (VOR); therefore, the aim of our study is to evaluate the contribution of multifrequency VOR testing in the evaluation of patients with AUVP. Methods: 22 patients (9 females and 13 males) with a diagnosis of AUVP were prospectively examined. Multifrequency testing included spontaneous nystagmus with visual fixation cancellation (SPN), Head Shaking Test (HST), bithermal air caloric test, and video Head Impulse Test (vHIT). The first examination was performed within one week of AUVP; follow-up examinations were performed 3 and 6 months apart. On the third examination, the Dizziness handicap inventory (DHI) questionnaire was completed. Results: The rate of the slow component of spontaneous and induced nystagmus during HST and the values of unilateral weakness (UW) during caloric testing decreased during follow-up with a statistically significant difference (P <0.05) between both the first and second and between the second and third examinations. On vHIT, there was a statistically significant increase in the gains of individual channels during follow-up. Dissociation of vHIT and caloric test results was found in 22.73% of patients on the second and 18.18% of patients on the third examination. There was a statistically significant difference in the changes in test results of patients with different DHI. Conclusion: Multifrequency VOR testing provides a comprehensive overview of the status of vestibular function, recovery dynamics, and clinical impact of residual vestibular dysfunction after AUVP.
Keywords:
vestibuloocular reflex – Video Head Impulse Test – caloric test – acute unilateral vestibulopathy – spontaneous nystagmus – Head Shaking Test
Sources
1. Strupp M, Bisdorff A, Furman J et al. Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria. J Vestib Res 2022; 32 (5): 389–406. Doi: 10.3233/VES-220201.
2. Adamec I, Krbot Skorić M, Handžić J at al. Incidence, seasonality and comorbidity in vestibular neuritis. Neurol Sci 2015; 36 (1): 91–95. Doi: 10.1007/s10072-014-1912-4.
3. Strupp M, Zingler VC, Arbusow V et al. Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004; 351 (4): 354–361. Doi: 10.1056/NEJMoa033280.
4. Kim G, Seo JH, Lee SJ et al. Therapeutic effect of steroids on vestibular neuritis: Systematic review and meta-analysis. Clin Otolaryngol 2022; 47 (1): 34–43. Doi: 10.1111/coa.13880.
5. Rujescu D, Herrling M, Hartmann AM et al. High-risk Allele for Herpes Labialis Severity at the IFNL3/4 Locus is Associated with Vestibular Neuritis. Front Neurol 2020; 1: 570638. Doi: 10.3389/fneur.2020.570638.
6. Gianoli G, Goebel J, Mowry S et al. Anatomic differences in the lateral vestibular nerve channels and their implications in vestibular neuritis. Otol Neurotol 2005; 26 (3): 489–494. Doi: 10.1097/01.mao.0000169787.99835.9f.
7. Büki B, Ward BK. Length of the Narrow Bony Channels May Not be the Sole Cause of Differential Involvement of the Nerves in Vestibular Neuritis. Otol Neurotol 2021; 42 (7): e918–e924. Doi: 10.1097/MAO.0000000000003161.
8. Čada Z, Černý R, Čakrt O. Závratě. Medicína hlavy a krku. Havlíčkův Brod: Tobiáš 2017.
9. Čada Z, Balatková Z, Černý R. Poruchy rovnováhy v dětském věku. Praha: Maxdorf 2023.
10. Striteska M, Skoloudik L, Valis M et al. Estimated Vestibulogram (EVEST) for Effective Vestibular Assessment. Biomed Res Int 2021; 2021: 8845943. Doi: 10.1155/2021/8845943.
11. Halmagyi G, Curthoys Ian, Halmagyi M. The video head impulse test in clinical practice. Neurol Sci Neurophys 2018; 35 (5): 1–5. Doi: 10.5152/NSN.2018.0001.
12. Strupp M, Grimberg J, Teufel J et al. Worldwide survey on laboratory testing of vestibular function. Neurol Clin Pract 2020; 10 (5): 379–387. Doi: 10.1212/CPJ.0000000000000744.
13. Shepard Neil, Jacobson GP. The caloric irrigation test. Handbook of Clinical Neurology 2016; 137: 119–131. Doi: 10.1016/B978-0-444- 63437-5.00009-1.
14. Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990; 116 (4): 424–427. Doi: 10.1001/archotol.1990.01870040046011.
15. Lee MY, Son HR, Rah YC et al. Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication. J Audiol Otol 2019; 23 (1): 33–38. Doi: 10.7874/jao.2018.00206.
16. Lacour M, Lopez C, Thiry A et al. Vestibular rehabilitation improves spontaneous nystagmus normalization in patients with acute unilateral vestibulopathy. Front Rehabil Sci 2023; 4: 1122301. Doi: 10.3389/fresc.2023.1122301.
17. Liu WY, Chen TS, Wang W et al. The analysis of the value of spontaneous nystagmus in peripheral vestibular hypofunction. J Clin Otorhinolaryng 2017; 31 (9): 678–681. Doi: 10.13201/ j.issn.1001-1781.2017.09.007.
18. Katsarkas A, Smith H, Galiana H. Head-shaking nystagmus (HSN): the theoretical explanation and the experimental proof. Acta Otolaryngol 2000; 120 (2): 177–181. Doi: 10.1080/000164800750000865.
19. Striteska M, Valis M, Chrobok V et al. Head-shaking-induced nystagmus reflects dynamic vestibular compensation: A 2-year follow--up study. Front Neurol 2022; 13: 949696. Doi: 10.3389/fneur.2022.949696.
20. Psillas G, Petrou I, Printza A et al. Video Head Impulse Test (vHIT): Value of Gain and Refixation Saccades in Unilateral Vestibular Neuritis. J Clin Med 2022; 11 (12). Doi: 10.3390/jcm11123467.
21. 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. Doi: 10.1016/ j.anl.2016.07.020.
22. Magliulo G, Gagliardi S, Ciniglio Appiani M et al. Vestibular neurolabyrinthitis: a follow-up study with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test. Ann Otol Rhinol Laryngol 2014; 123 (3): 162–173. Doi: 10.1177/0003489414522974.
23. Asprella-Libonati G. Lateral canal BPPV with Pseudo-Spontaneous Nystagmus masquerading as vestibular neuritis in acute vertigo: a series of 273 cases. J Vestib Res 2014; 24 (5–6): 343–349. Doi: 10.3233/ves-140532.
24. Lee HJ, Kim SH, Jung J. Long-Term Changes in Video Head Impulse and Caloric Tests in Patients with Unilateral Vestibular Neuritis. Korean J Otorhinolaryngol-Head Neck Surg 2019; 62 (1): 23–27. Doi: 10.3342/kjorl-hns.2017.01 081
25. Waissbluth S, Sepúlveda V. Dissociation between Caloric and Video Head Impulse Tests in Dizziness Clinics. Audiol Res 2022; 12 (4): 423–432. Doi: 10.3390/audiolres12040043.
26. Zellhuber S, Mahringer A, Rambold HA. Relation of video-headimpulse test and caloric irrigation: a study on the recovery in unilateral vestibular neuritis. Eur Arch Otorhinolaryngol 2014; 271 (9): 2375–2383.
27. Bartolomeo M, Biboulet R, Pierre G et al. Value of the video head impulse test in assessing vestibular deficits following vestibular neuritis. Eur Arch Otorhinolaryngol 2014; 271 (4): 681–688.
28. Türk B, Akpinar M, Kaya KS et al. Benign Paroxysmal Positional Vertigo: Comparison of Idiopathic BPPV and BPPV Secondary to Vestibular Neuritis. Ear Nose Throat J 2021; 100 (7): 532–535. Doi: 10.1177/0145561319871234.
29. Staab JP, Eckhardt-Henn A, Horii A et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res 2017; 27 (4): 191–208. Doi: 10.3233/VES-170 622.
30. Bronstein AM, Dieterich M. Long-term clinical outcome in vestibular neuritis. Curr Opin Neurol 2019; 32 (1): 174-180. Doi: 10.1097/ WCO.0000000000000652.
31. Li J, Zhang Y, Shi C, Liao S et al. Correlation between video head impulse test parameters and DHI score in patients with vestibular neuritis. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36 (11): 854–858. Doi: 10.13201/ j.issn.2096-7993.2022.11.009.
32. Redondo-Martínez J, Bécares-Martínez C, Orts-Alborch M et al. Relationship between video head impulse test (vHIT) and caloric test in patients with vestibular neuritis. Acta Otorrinolaringol Esp 2016; 67 (3): 156–161. Doi: 10.1016/ j.otorri.2015.07.005.
ORCID autorky
K. Kozynkina-Marchenko 0009-0001-8751-2871.
Přijato k recenzi: 4. 11. 2023
Přijato k tisku: 9. 1. 2024
MUDr. Kateryna Kozynkina-Marchenko
Otorinolaryngologické oddělení
Orlickoústecká nemocnice
Čs. armády 1076
562 18 Ústí nad Orlicí
kateryna.kozynkina@gmail.com
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
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