Horizontal and Vertical vHIT in Acute Unilateral Vestibular Neuritis Patients Pages 59-66

Mohamed M. Abdeltawwab1 and Ahmed Khater2

1ORL Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt & Audio-Vestibular Clinic, ORL Department, KFMMC Hospital, Dhahran, KSA; 2ORL Department, Faculty of Medicine, Zagazig University, Egypt & ENT medical center, Riyadh, Saudi Arabia

DOI: http://dx.doi.org/10.12970/2308-7978.2014.02.03.4

Abstract: Objectives: Vestibular neuritis (VN) is an acute peripheral vestibulopathy that manifests with acute spontaneous vertigo, nausea and sometimes vomiting, and postural imbalance. Video head impulse test (vHIT) is an objective measure of responses of semicircular canals using high speed video measures of eye movement response to head impulses. The purpose of this study was to measure and analyze horizontal and vertical vestibular canals responses measured by vHIT in acute unilateral VN and to compare the results with the un-affected sides in those patients.

Design: The responses of vHIT were obtained from 31 patients with acute VN (16 females and 15 males) ranging in age from 24 to 54 years. Audiological and vestibular assessments were done to all participants that include pure tone, speech audiometry, tympanometry, acoustic reflexes, vestibular bed side evaluation and caloric testing.

Results: The mean age of VN patients were 38.03 ± 7.96 years. The right side was affected in 14 and left in 17 patients. The gain of vHIT was reduced in the affected side of VN which was statistically significant when compared with the un-affected side. Isolated horizontal canal was observed in 15 patients whereas mixed horizontal and vertical canals were observed in 9 patients. Vertical canals were affected in 7 out of 31 patients.

Discussion and Conclusion: Acute VN patients do have single or multi-semicircular canals affection which can be objectively measured for each canal by vHIT. The lesion is manifested by reduction in amplitude response for affected canal which can affect the superior division mainly and to less extent the inferior vestibular division.

Keywords: Vestibular neuritis, video head impulse test, vertigo, acute peripheral vertigo, acute vestibulopathy. Read more