Diagnóstico y tratamiento actual de la neuritis vestibular: una revisión narrativa

Abstract

Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease.

The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs.

To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics.

Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

Chang Hoon Bae, Hyung Gyun Na, Yoon Seok Choi. Current diagnosis and treatment of vestibular neuritis: a narrative review. J Yeungnam Med Sci 2022;39(2):81-88

https://doi.org/10.12701/yujm.2021.01228

Comentario del experto

La neuritis vestibular  es el tercer trastorno vestibular periférico más común después del vértigo posicional paroxístico benigno y la enfermedad de Ménière. Para diagnosticar con precisión la neuritis vestibular, se realizan varias pruebas de diagnóstico, como la prueba de impulso cefálico, la prueba calórica bitérmica y la prueba de potencial miogénico evocado vestibular. El tratamiento de la neuritis vestibular puede hacerse a través de terapia sintomática (atención de apoyo generalizada y administración de supresores vestibulares y antieméticos), con medicamentos específicos o con   rehabilitación vestibular.

Dr. Jesús Benítez del Rosario
Servicio ORL. Hospital Doctor Negrín.
Las Palmas de Gran Canaria