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  Contents > Previous page > Article detail print Order
o Issue N# 1 - 2015 o

OTONEUROLOGY

Vestibular neuritis: Evaluation and effect of vestibular rehabilitation


Authors : Lorin P, Donnard M, Foubert F. (Le Mans)

Ref. : Rev Laryngol Otol Rhinol. 2015;136,1:21-27.

Article published in english
Downloadable PDF document english



Summary : Vestibular neuritis (VN) is a caloric vestibular areflexia that occurs suddenly, and whose compensation can take several weeks, sometimes several months. Usually these patients are rehabilitated, but the most affected patients (cervical vestibular evoked myogenic potential (cVEMP) absent) have a worse progno­sis of vestibulo-ocular compensation. Thanks to sympto­matic, videographic and posturographic evaluation tools, we objectify and quantify which factors influence the recovery or more accurately the compensation of this type of disorder. Equipment and method: We have colligated 34 obser­va­tions of VN whose beginning could be precisely dated. These 34 uni­lateral caloric areflexic patients had a symptoma­tic evaluation (SE) with scales (vertigo symptom scale, dizzi­ness handicap inventory, short form 36), an evaluation of the vestibulo-ocular reflex (VOR) (spontaneous nystagmus, head shaking test, mastoid bone skull vibration test, and finally an evaluation of the vestibulo-spinal function (VSF) on a dynamic posturo­graphy platform (DPY). On the other hand were evaluated eight elements supposed to influence (influence factors FI) the care and / or the outcome of the treatment (age, cVEMP absent, duration of deficiency, sports and walk practice, rehabilitation of VOR, rehabilitation of VSF, waiting period before appli­ca­tion of rehabilitation, vertigo medications treatment). Results: By comparing averages and with a Fischerís exact test, we can show here that the medical treat­ment, the waiting period before the application of the rehabi­lita­tion, the number of rehabi­li­ta­tion sessions or the type of rehabilitation influence only partially the state of health of neuritis. The age of the patients and absent cVEMP donít have a major influence either. However, patients with the most impor­tant physical activity feel better from a symptomatic point of view, over a long period after the episode. The effect of reha­bi­litation might be tempo­rary if daily activity is minimal. Conclusion: The evaluation of the vestibulo-ocular reflex has long remained the main element for the evaluation of the state of health of vestibular neuritis. But if you use in addition pos­tu­ro­­graphy and symptomatic scales to assess the state of health, the neuritis considered to be compensated with the VOR will not always be symptomatically compensated. Estimating the functional recovery of neuritis canít be limited to estimating or quantifying the VOR. Rehabi­li­tating neuritis canít be limited to rehabilitating the VOR. Fina­l­ly we show here that physical activity is probably more neces­sa­ry than any type of rehabilita­tion.

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