J Audiol Otol.  2021 Apr;25(2):89-97. 10.7874/jao.2020.00360.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

Affiliations
  • 1Division of Otolaryngology, Department of Neurosciences, Padova University, Padova, Italy
  • 2Division of Otolaryngology, Department of Specialistic Surgeries, Santa Maria della Misericordia Hospital, Rovigo, Italy
  • 3Division of Otolaryngology, Department of Surgery, SS. Giovanni e Paolo Hospital, Venezia, Italy
  • 4Division of Otolaryngology, Department of Surgery, Santa Maria Nuova Hospital, Reggio Emilia, Italy

Abstract

Background and Objectives
Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN.
Subjects and Methods
Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging.
Results
Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome).
Conclusions
Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

Keyword

Benign paroxysmal positional vertigo; Facial paralysis; Head impulse test; Vestibular neuritis
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