Research in Vestibular Science

Case Report

Unilateral Vestibular Neuritis after Snakebite: Is There a Causal Relationship?: Jae-Myung Kim, Hyeon-Joong Park, Shina Kim, Seung-Han Lee; Res Vestib Sci. 2020;19(4):144-148. Published online December 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.4.144

Abstract PDF: Vast majority of triggering factors preceding vestibular neuritis (VN) are unknown, although many cases are associated with viral infection. A 55-year-old woman was bitten by a viper on her right hand, and she was treated with antivenom at the primary clinic. Three days later, acute persistent vertigo was developed. Neuro-otologic examinations revealed spontaneous left-beating nystagmus and abnormal head impulse test in the right side. Taken together with negative result of brain magnetic resonance imaging, she was diagnosed with a right VN. Various neurological complications such as paralysis, optic neuritis, and stroke can occur after snakebite envenoming. In this case, given the time interval between snakebite and development of dizziness, snakebite envenoming might be a possible predisposing factor of VN as a proinflammatory condition rather than a direct cause of VN. Furthermore, the VN of this case was probably caused by late adverse reactions after antivenom administration. Since about 10% of the snake-bitten patients have complained dizziness, detailed neuro-otologic evaluations may lead to a proper understanding of pathomechanism and a correct diagnosis.

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