gms | German Medical Science

Introduction: Sudden unilateral loss of labyrinth function or hypofunction without hearing loss is a well known clinical feature. It is called “neuropathia vestibularis” in contrast to the vestibular dysfunction of central origin. Discussions about its origin an proper therapy are controverse.

Methods: We analysed vestibular findings of 60 patients with vestibular neuronitis retrospectively. Within the first three days of acute vestibular dysfunction, computerized (VOG-) tests of spontaneous nystagmus and caloric irrigation were performed. The Otolith function was proved by changing the patient´s position from Hallpike to Anti- Hallpike- position during caloric testing and by vestibular evoked myogenic potentials (VEMPS) testing.

Results: 42 out of 60 patients showed an unilateral labyrinthal hypofunction or absent caloric response of the lesioned side, 18 out of 60 patients had a normal response. In 23 out of 34 patients we found a changed nystagmus direction after alterning changing the position during caloric testing. In 10 patients there was no changed nystagmus direction on one side, though in one patient it was not found on both sides. 9 out of 23 patients showed no VEMPs on the lesioned side and normal VEMPs on the other side.

Conclusion: In many cases Vestibular neuronitis refers to the semicircular canals as well as to macula dysfunction. A detailed neurootolgic examination may be usefull to assess the dimension, prognosis and cause of this illness.