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Research in Vestibular Science > Volume 14(4); 2015 > Article
Research in Vestibular Science 2015;14(4): 132-138.
전정신경염에서 비디오두부충동검사를 이용한 전정기능 회복 평가
, , , , , 김준현1, 이태경1, 이상우1, 최나리2, 이승철3, 성기범1
순천향대학교 의과대학 1부천병원 신경과학교실, 2서울병원 신경과학교실, 3천안병원 신경과학교실
Assessment of Vestibular Functional Recovery Using Video Head Impulse Test in Vestibular Neuritis
Jun Hyun Kim, Tae Kyeong Lee, Sang Woo Lee, Nari Choi, Seungcheol Lee, Ki Bum Sung
1Department of Neurology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. xorudoc@schmc.ac.kr
2Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, Korea.
3Department of Neurology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
ABSTRACT
Objective:   The video head impulse test (vHIT) is useful for evaluation of high frequency vestibulo-ocular reflex. There are a few reports regarding the recovery of head impulse test in vestibular neuritis (VN) but the factors for the recovery were not studied. The study aimed to identify the recovery patterns of vHIT in VN and the factors influencing the recovery.
Method:   Among 31 patients with acute VN, 18 patients with identified recovery pattern were selected. We conducted serial checks of subjective vertigo and spontaneous nystagmus until discharged (1?8 days), and scheduled vHITs. We found three patterns in serial vHITs during follow-ups and analyzed the relationship of initial vestibular function tests, serial check-ups of subjective vertigo, bedside neuro-otologic tests, and vHITs.
Results:   Five patients showed normal vHIT gain in acute stage (non-damaged pattern) and 8 patients’ gains were recovered after 30 days after symptom onset (early recovered pattern). Poor recovery pattern was found in 5 patients (poorly recovered pattern). There were relationship between vHIT recovery patterns and the severity of vestibular dysfunctions. Duration of spontaneous nystagmus (until grade 1), degree of subjective visual vertical tilt, ocular vestibular myogenic potential abnormalities, and abnormality of rotatory chair test were all related to poorly recovered vHIT patterns. All poor recovery patients had residual symptom at 30 days after symptom onset.
Conclusion:   The vHIT may give clinicians useful hints in predicting prognosis in VN, and the recovery of vHIT would be delayed if the damage were more extensive.
Keywords: Head impulse test; Reflex; Vestibulo-ocular; Vestibular neuronitis
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