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Original Articles
- Does dimenhydrinate delay recovery of vestibular ocular reflex in acute unilateral vestibulopathy? A retrospective comparative study
- Minah Shin, Chae-Young Kim, Ji Eun Choi, Jae Yun Jung, Min Young Lee
- Res Vestib Sci. 2024;23(3):89-94. Published online September 15, 2024
- DOI: https://doi.org/10.21790/rvs.2024.006
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Abstract
PDF - Objectives
Acute unilateral vestibulopathy (UVP), also known as vestibular neuritis, is the third most common peripheral vestibulopathy. The acute autonomic symptoms of UVP can be controlled by the H1-receptor antagonist dimenhydrinate. Despite concerns about prolonged recovery from suppressed vestibular compensation when using dimenhydrinate, research is limited. Thus, we investigated the effect of dimenhydrinate on the recovery of UVP patients.
Methods
We retrospectively analyzed patients who were diagnosed with UVP from April 2018 to April 2022. The patients were divided into those who were prescribed dimenhydrinate during admission and those who were not. Recovery from UVP was defined subjectively and objectively. Subjective recovery (SR) had occurred in a patient whose dizziness clearly subsided. Objective recovery (OR) was used when the video head-impulse test (VHIT) or rotary chair test (RCT) no longer indicated vestibular dysfunction.
Results
Dimenhydrinate was prescribed to 15 patients (19.0%) during admission. The dimenhydrinate group had smaller proportions of SR and OR at 3 months after diagnosis of UVP. In terms of VHIT, the non-dimenhydrinate group had a greater increase in gain for the 3 months than the dimenhydrinate group in the semicircular canals when measured by the VHIT. The difference in gain between the two groups was significant at 0.16 Hz during follow-up RCT.
Conclusion
These results suggest that dimenhydrinate should be carefully used in UVP patients as it may have a negative effect on vestibular compensation.
- The Clinical Efficacy of Vestibular Function Tests in Patients with Acute Unilateral Vestibulopathy
- Bong-Hui Kang, Jae-Il Kim
- Res Vestib Sci. 2018;17(2):49-54. Published online June 15, 2018
- DOI: https://doi.org/10.21790/rvs.2018.17.2.49
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Abstract
PDF
- Objectives
Aim of this study is to investigate the clinical efficacy of the vestibular function tests (VFTs) and the predictability of lesion side of vestibular asymmetry parameters in acute unilateral peripheral vestibulopathy.
Methods
Medical records and results of VFTs (caloric, rotatory chair, and head impulse tests) of 57 patients with acute unilateral vestibulopathy were reviewed retrospectively. The VFTs were examined within 7 days after the clinical onset.
Results
For the caloric test, 74% showed significant canal paresis and the predictability of lesion side was 88%. For the sinusoidal harmonic acceleration test, 91% had low gain in at least 1 Hz, phase lead showed 70%, 89% showed phase asymmetry and the predictability of lesion side was 90%. For velocity step test, 67% had abnormal Tc asymmetry and the predictability of lesion side was 95%. In bedside head impulse test (HIT), abnormal catch up saccades were observed in 89% and the predictability of lesion side was 100%. For the video HIT, cover or overt catch-up saccades were observed in 95% and the predictability of lesion side was 100%. One hundred percent (100%) had low gain on the video HIT, but the lesion sides were uncertain because of bilateral involvements or artifacts.
Conclusions
The most important things in the diagnosis of acute unilateral vestibulopathy are typical clinical symptoms and spontaneous nystagmus. A combination of rotatory, caloric, and HITs will result in a more complete examination of the vestibular system. Among them, HIT is recommended as the best tool in acute unilateral vestibulopathy.
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