Ahn Sung Hwan, Shin Jung Eun, Kim Chang-Hee
Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
J Clin Neurosci. 2017 Jul;41:107-110. doi: 10.1016/j.jocn.2017.02.064. Epub 2017 Apr 13.
Vestibular neuritis is one of the most common peripheral causes of acute vestibular syndrome, of which the diagnosis is generally based on a comprehensive interpretation of clinical and laboratory findings following reasonable exclusion of other disorders. This study aimed to investigate the final diagnosis of patients admitted to hospital under the clinical impression of vestibular neuritis who showed no unilateral caloric paresis. Forty-five patients who visited the emergency department with isolated acute spontaneous vertigo were included. Among them, six patients (13%) developed definitive spontaneous vertigo lasting longer than 20min again after discharge from hospital, accompanied by hearing loss, which was audiometrically documented, leading to a final diagnosis of definite Ménière's disease. Nine patients (20%) revisited our clinic with recurrent episodic vertigo without any documented hearing loss or auditory symptoms such as hearing loss, tinnitus or ear fullness, which led to a final diagnosis of possible Ménière's disease. In four patients (9%), initial spontaneous vertigo and nystagmus changed to positional vertigo and nystagmus on the second hospital day. In 26 patients (58%), neither another episode of vertigo nor auditory symptoms developed during follow-up period (7-92months), a condition to which the authors gave an arbitrary diagnosis of "mild unilateral vestibular deficit". In conclusion, patients admitted to hospital under clinical impression of vestibular neuritis may have various final diagnoses, and "mild unilateral vestibular deficit" was the most common final diagnosis among patients who did not meet the diagnostic criteria of vestibular neuritis.
前庭神经炎是急性前庭综合征最常见的外周病因之一，其诊断通常基于在合理排除其他疾病后，对临床和实验室检查结果的综合解读。本研究旨在调查以前庭神经炎临床印象入院但无单侧冷热试验麻痹的患者的最终诊断情况。纳入了45例因孤立性急性自发性眩晕就诊于急诊科的患者。其中，6例患者（13%）出院后再次出现明确的自发性眩晕，持续时间超过20分钟，并伴有听力损失，听力检查有记录，最终确诊为明确的梅尼埃病。9例患者（20%）因反复发作性眩晕再次就诊于我们的诊所，无任何记录的听力损失或听觉症状，如听力损失、耳鸣或耳闷胀感，最终诊断为可能的梅尼埃病。4例患者（9%）在住院第二天，初始的自发性眩晕和眼球震颤转变为位置性眩晕和眼球震颤。26例患者（58%）在随访期间（7 - 92个月）既未出现眩晕复发，也未出现听觉症状，作者对这种情况任意诊断为“轻度单侧前庭功能减退”。总之，以前庭神经炎临床印象入院的患者可能有多种最终诊断，“轻度单侧前庭功能减退”是不符合前庭神经炎诊断标准的患者中最常见的最终诊断。
