Diagnostic criteria for vestibular neuritis
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1 Equilibrium Res Vol. (4) Bárány Society Diagnostic criteria for vestibular neuritis Toshihisa Murofushi Department of Otolaryngology Teikyo University School of Medicine Mizonokuchi Hospital The authors introduced the diagnostic criteria recently revised by the Japan Society for Equilibrium Research. In addition, several issues related to diagnosis of vestibular neuritis were discussed. Firstly, partial involvement of the vestibular nerve was discussed. Conventionally, in order to prove peripheral vestibular disorders, caloric tests have been used. However, caloric tests cannot clarify disorders of the inferior vestibular nerve with preservation of the superior vestibular nerve function. If inferior vestibular neuritis is recognized as a kind of vestibular neuritis, the diagnostic criteria need further revision. Additionally, the head impulse test should be considered as a new diagnostic tool for vestibular neuritis. Secondly, the authors stated that vestibular neuritis could include vestibular neurolabyrinthitis and vestibular labyrinthitis in addition to vestibular neuritis as the current diagnostic criteria do not require differentiation of retro-labyrinthine lesions from labyrinthine lesions. Thirdly, the number of vertigo attack was discussed. Vertigo associated with vestibular neuritis should not strictly occur as a single episode, but rather as several attacks. Finally, the authors stated that vestibular neuritis should be changed to another term in order to express its actual states. Key words: vestibular neuritis, inferior vestibular neuritis, caloric test, diagnostic criteria, head impulse test, VEMP Ruttin Dix & Hallpike ( 310 )
2 Equilibrium Res Vol. (4) Dix MR & Hallpike CS vestibular neuronitis 8 vestibular neuritis Definite vestibular neuritis Probable vestibular neuritis canal paresis CP canal paresis caloric paresis vestibular paresis unilateral vestibular weakness CP ( 311 )
3 Equilibrium Res Vol. (4) Australian (N=47) Japanese N=58) 0% 50% 100% cvemp Australian Japanese Fitzgerald-Hallpike 226 ml 40 sec head impulse test HIT vhit vhit vhit vhit cvemp cvemp cvemp cvemp vhit cvemp Chihara Nadol Dix & Hallpike galvanic body sway test ( 312 )
4 Equilibrium Res Vol. (4) a. b. c. vestibular labyrinthitis vestibular neurolabyrinthitis vestibular neuritis A. B. C. galvanic VEMP Murofushi galvanic cvemp Dix & Hallpike ( 313 )
5 Equilibrium Res Vol. (4) Bárány Society Ruttin B: Zur Differentialdiagnose der Labyrinth und Hōrnenervenkrankungen. Z Ohrenheilkund 57: , 1909 Dix MR, Hallpike CS: The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 61: , 1952 Equilibrium Res Supp 11: 29 57, 1995 Equilibrium Res 76: , 2017 Equilibrium Res 75: , 2016 Fitzgerald G, Hallpike CS: Studies in human vestibular function: I. observation on the directional preponderance ( Nystagmusbereitschaft ) of caloric nystagmus resulting from cerebral lesions. Brain 65: , 1942 McDougall HG, Weber KP, McGarvie LA, et al.: The video head impulse test. Neurology 73: , 2009 Murofushi T, Halmagyi GM, Yavor RA, et al.: Absent vestibular evoked potentials in vestibular neurolabyrinthitis; an indicator of involvement of the inferior vestibular nerve? Arch Otolaryngol Head Neck Surg 122: , 1996 Murofushi T: Clinical application of vestibular evoked myogenic potential (VEMP). Auris Nasus Larynx 43: , 2016 Chihara Y, Iwasaki S, Murofushi T, et al.: Clinical Characteristics of Inferior Vestibular Neuritis. Acta Otolaryngol 132: , 2012 Kim JS, Kim HJ: Inferior vestibular neuritis. J Neurol 259: , 2012 Nadol JB : Vestibular neuritis. Otolaryngol Head Neck Surg 112: , 1995 ( 314 )
6 Equilibrium Res Vol. (4) Murofushi T, Monobe H, Ozeki H, et al.: The site of lesions in vestibular neuritis ; study by galvanic VEMP. Neurology 61: , 2003 Taylor RL, McGarvie LA, Reid N, et al.: Vestibular neuritis affects both superior and inferior vestibular nerves. Neurology 87: , 2016 Murofushi T, Iwasaki S, Ushio M: Recovery of vestibular evoked myogenic potentials after a vertigo attack due to vestibular neuritis. Acta Otolaryngol 126: , 2006 ( 315 )
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