The Different Stages of Vestibular Neuritis from the Point of View of the Video Head Impulse Test

Abstract

Vestibular neuritis (VN) is one of the most common causes of acute vestibular syndrome (AVS). Quantifying the vestibulo-ocular reflex (VOR) gain by the video Head Impulse Test (vHIT) could provide useful information to diagnose VN. This study aims to retrospectively evaluate the VOR gain values during the acute and subacute stages of the VN and to correlate these values with the patients’ dizziness-related handicap. Medical record of 28 patients with VN were reviewed. Patients were assigned to two groups according to the time since the acute vestibular syndrome (AVS). One group with patients assessed within seventy-two hours since the AVS (AVSg) and one group with patients evaluated from four days to six weeks since the AVS (PAVSg). VOR gain was evaluated in all selected patients and correlated to Dizziness Handicap Inventory (DHI). Significant differences were found in the between-subjects analysis in DHI score (p = 0.000) and in the ipsilesional hVOR gain values (p = 0.001). The correlation analysis showed significant results (p = 0.017) between DHI score (40 ± 16.08) and ipsilesional VOR gain (0.54 ± 0.09) in the PAVSg. Patients evaluated within 72 h since the AVS showed anticompensatory saccades (AcS) turning the head toward the contralesional side. Patients with unilateral Superior VN (SVN) could have dissimilar hVOR gain values and DHI score according to the damage of the VIII pair of cranial nerves. AcS in the contralesional side is a sign of acute phase in patients with unilateral SVN.