Res Vestib Sci.  2020 Dec;19(4):144-148. 10.21790/rvs.2020.19.4.144.

Unilateral Vestibular Neuritis after Snakebite: Is There a Causal Relationship?

• Kim JM
• Park HJ
• Kim S
• Lee SH

• KMID: 2510952
• DOI: http://doi.org/10.21790/rvs.2020.19.4.144

Abstract

Vast majority of triggering factors preceding vestibular neuritis (VN) are unknown, although many cases are associated with viral infection. A 55-year-old woman was bitten by a viper on her right hand, and she was treated with antivenom at the primary clinic. Three days later, acute persistent vertigo was developed. Neuro-otologic examinations revealed spontaneous left-beating nystagmus and abnormal head impulse test in the right side. Taken together with negative result of brain magnetic resonance imaging, she was diagnosed with a right VN. Various neurological complications such as paralysis, optic neuritis, and stroke can occur after snakebite envenoming. In this case, given the time interval between snakebite and development of dizziness, snakebite envenoming might be a possible predisposing factor of VN as a proinflammatory condition rather than a direct cause of VN. Furthermore, the VN of this case was probably caused by late adverse reactions after antivenom administration. Since about 10% of the snake-bitten patients have complained dizziness, detailed neuro-otologic evaluations may lead to a proper understanding of pathomechanism and a correct diagnosis.

Keyword

Snake bites; Vestibular neuritis; Acute vestibular syndrome; 독사교상; 전정신경염; 급성전정증후군