Evaluation of vestibular function using video Head Impulse Test, caloric test and VEMP in patients with vestibular neuritis

Abstract

The aim of this study was to classify unilateral vestibular neuritis (VN) with caloric testing, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and the video head impulse test (vHIT). Eight Patients (3 males and 5 females, mean age 55.6 years) with VN were studied. cVEMP and oVEMP (105 dBSPL 500 Hz short tone burst stimulation) were recorded. The caloric test and vHIT for the 3 semicircular canal were performed. The caloric test, cVEMP and oVEMP in combination with vHIT were able to allow the classification of 4 types of VN: entire VN, superior VN, inferior VN, and ampullary VN. In our case, 75% of the cases were entire VN, 12.5% were superior VN, and 12.5% were inferior VN. Three patients had only deficits of the horizontal and/or inferior semicircular canals or their ampullary nerves. One of eight VN patients had symptoms similar to benign paroxysmal positional vertigo after three weeks onset of VN. The results lead us to believe that clinical VN comprises vestibular neuritis and vestibular labyrinthitis. Currently, in Japan it would be essential that there is canal paresis in caloric test for VN diagnosis. We hope to include inferior VN within the diagnosis criteria of VN in the near future.