Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Japan.
Department of Otolaryngology, Tokyo Teishin Hospital, Japan.
Auris Nasus Larynx. 2020 Oct;47(5):905-908. doi: 10.1016/j.anl.2019.07.007. Epub 2019 Jul 27.
We report a case of acute vestibulopathy with the simultaneous involvement of both superior and inferior vestibular nerves on both sides. A 36-year-old female presented with dizziness, oscillopsia and a walking impairment subsequent to a high fever. Vestibular function tests including caloric testing, video head impulse testing (vHIT) and cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) were performed. In the first examination, vHIT and caloric testing showed severe impairments in all three semicircular canals in each ear, and both cVEMPs and oVEMPs were absent on both sides. During a 1-year follow-up, the gain of vHIT gradually recovered by more than 0.5 to normal. cVEMPs also recovered to normal on both sides while oVEMPs remained absent on both sides. This is the first reported case of acute bilateral vestibulopathy with simultaneous involvement of both superior and inferior vestibular nerves on both sides. Repeated evaluation of vestibular function using vHIT, cVEMPs and oVEMPs is helpful to assess the time course of recovery in patients with vestibulopathy.
我们报告一例双侧同时累及上、下前庭神经的急性前庭病。一名 36 岁女性因高热后出现头晕、视振和行走不稳。进行了前庭功能测试,包括冷热试验、视频头脉冲试验(vHIT)和颈肌和眼肌前庭诱发肌源性电位(cVEMPs 和 oVEMPs)。首次检查时,双耳各三个半规管的 vHIT 和冷热试验均严重受损,双侧 cVEMPs 和 oVEMPs 均缺失。在 1 年的随访中,vHIT 的增益逐渐恢复到正常的 0.5 以上。双侧 cVEMPs 也恢复正常,而双侧 oVEMPs 仍缺失。这是首例双侧同时累及上、下前庭神经的急性双侧前庭病的报告病例。使用 vHIT、cVEMPs 和 oVEMPs 对前庭功能进行反复评估有助于评估前庭病患者的恢复时间过程。