Martin-Sanz Eduardo, Rueda Almudena, Esteban-Sanchez Jonathan, Yanes Joaquin, Rey-Martinez Jorge, Sanz-Fernandez Ricardo
*Department of Otolaryngology †Department of Neurology, University Hospital of Getafe, Madrid ‡Otolaryngology Unit ORL Gipuzkoa, Quiron-Donostia Clinic, San Sebastián, Spain.
Otol Neurotol. 2017 Aug;38(7):e203-e208. doi: 10.1097/MAO.0000000000001468.
To evaluate vestibular restoration and the evolution of the compensatory saccades in acute severe inflammatory vestibular nerve paralysis, including vestibular neuritis and Ramsay Hunt syndrome with vertigo.
Prospective.
Tertiary referral center.
Vestibular neuritis (n = 18) and Ramsay Hunt syndrome patients with vertigo (n = 13) were enrolled.
After treatment with oral corticosteroids, patients were followed up for 6 months.
Functional recovery of the facial nerve was scored according to the House-Brackman grading system. Caloric and video head impulse tests were performed in every patient at the time of enrolment. Subsequently, successive video head impulse test (vHIT) exploration was performed at the 1, 3, and 6-month follow-up.
Eighteen patients with vestibular neuritis and 13 with Ramsay Hunt syndrome and associated vertigo were included. Vestibular function was significantly worse in patients with Ramsay Hunt syndrome than in those with vestibular neuritis. Similar compensatory saccades velocity and latency values were observed in both groups, in both the caloric and initial vHIT tests. Successive vHIT results showed a significantly higher vestibulo-ocular reflex gain recovery in vestibular neuritis patients than in Ramsay Hunt syndrome patients. A significantly faster reduction in the latency, velocity, and organization of the compensatory saccades was observed in neuritis than in Ramsay Hunt syndrome patients.
In addition to the recovery of the vestibulo-ocular reflex, the reduction of latency, velocity and the organization of compensatory saccades play a role in vestibular compensation.
评估急性重症炎症性前庭神经麻痹（包括前庭神经炎和伴眩晕的拉姆齐·亨特综合征）中的前庭恢复情况及代偿性扫视的演变。
前瞻性研究。
三级转诊中心。
纳入前庭神经炎患者（n = 18）和伴眩晕的拉姆齐·亨特综合征患者（n = 13）。
口服皮质类固醇治疗后，对患者进行6个月的随访。
根据House - Brackman分级系统对面神经功能恢复进行评分。每位患者在入组时进行冷热试验和视频头脉冲试验。随后，在1个月、3个月和6个月随访时进行连续视频头脉冲试验（vHIT）检查。
纳入18例前庭神经炎患者和13例拉姆齐·亨特综合征及相关眩晕患者。拉姆齐·亨特综合征患者的前庭功能明显比前庭神经炎患者差。在冷热试验和初始vHIT试验中，两组的代偿性扫视速度和潜伏期值相似。连续vHIT结果显示，前庭神经炎患者的前庭眼反射增益恢复明显高于拉姆齐·亨特综合征患者。与拉姆齐·亨特综合征患者相比，神经炎患者代偿性扫视的潜伏期、速度和协调性的降低明显更快。
除前庭眼反射的恢复外，代偿性扫视的潜伏期、速度降低及协调性在前庭代偿中发挥作用。
