Vestibular neuritis

Abstract

The aim of the present paper was to provide a comprehensive review of vestibular neuritis. This disorder was described for the first time by Ruttin in 1909 and Nylen coined the term vestibular neuritis in 1924. Dix and Hallpike reported 100 cases with vestibular neuritis including cases with either single or multiple attacks of vertigo. A more restricted diagnostic criterion limited to a single severe attack of vertigo with a subsequent unilateral deficit in caloric response was adopted by the Japan Society For Equilibrium Research and Research Group for Vestibular Disorder of the Ministry of Health, Labour and Welfare of Japan. A human temporal bone histopathological study demonstrated severe atrophic changes of one or more nerve trunks of the superior vestibular nerve, with or without their associated sense organs. The above histological findings suggested viral infection rather than vascular occlusion. However, the cause of vestibular neuritis remains uncertain. Previous histopathological studies exhibited atrophic changes limited to the superior division of the vestibular nerve. In addition, recent studies revealed that some patients demonstrated vestibular dysfunction limited to the inferior division or superior/inferior division of the vestibular nerve. Antiviral agents (valacyclovir) have failed to demonstrate any improvement in vestibular neuritis-related vestibular function. Furthermore, the effectiveness of corticosteroids in the management of patients with vestibular neuritis has not been established. A Cochrane Database Systematic Review reported insufficient evidence to support the administration of corticosteroids to patients with vestibular neuritis in 2011.