Res Vestib Sci.  2019 Mar;18(1):19-23. 10.21790/rvs.2019.18.1.19.

Visuospatial Dysfunction in Patients With the Right Vestibular Neuritis

Affiliations
  • 1Department of Neurology, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. ohsun@jbnu.ac.kr
  • 2Biomedical Research Institute, Chonbuk National University, Jeonju, Korea.

Abstract

Acute vestibular neuritis (VN) is characterized by acute/subacute vertigo with spontaneous nystagmus and unilateral loss of semicircular canal function. Vestibular system in human is represented in the brain bilaterally with functional asymmetries of the right hemispheric dominance in the right handers. Spatial working memory entails the ability to keep spatial information active in working memory over a short period of time which is also known as the right hemispheric dominance. Three patients (patient 1, 32-year-old female; patient 2, 18-year-old male; patient 3, 63-year-old male) suffered from acute onset of severe vertigo, nausea and vomiting. Patients 1 and 2's examination revealed VN on the right side showing spontaneous left beating nystagmus and impaired vestibular ocular reflex on the right side in video head-impulse and caloric tests. Patient 3's finding was fit for VN on the left side. We also evaluated visuospatial memory function with the block design test in these 3 VN patients which discovered lower scores in patients 1 and 2 and the average level in patient 3 compare to those of healthy controls. Follow-up block design test after resolved symptoms showed within normal range in both patients. Our cases suggest that the patients with unilateral peripheral vestibulopathy may have an asymmetrical effect on the higher vestibular cognitive function. The right VN can be associated with transient visuospatial memory dysfunction. These findings add the evidence of significant right hemispheric dominance for vestibular and visuospatial structures in the right-handed subjects, and of predominant dysfunction in the hemisphere ipsilateral to the peripheral lesion side.

Keyword

Vestibular neuritis; Visuospatial memory; Vestibular; Block design; Hemispheric dominance

MeSH Terms

Adolescent
Adult
Brain
Caloric Tests
Cognition
Female
Follow-Up Studies
Humans
Male
Memory
Memory, Short-Term
Middle Aged
Nausea
Reference Values
Reflex
Semicircular Canals
Vertigo
Vestibular Neuronitis*
Vomiting
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