Conraux C
Service d'oto-rhino-laryngologie, hôpital de Hautepierre, Strasbourg.
Rev Prat. 1994 Feb 1;44(3):324-7.
Vestibular neuronitis is an acute disorder of the vestibular apparatus which manifests by sudden vertigo, without apparent cause, and without auditory or neurological symptoms. Clinically and by thermal stimulation tests, it is characterised by unilateral peripheral vestibular deficit. Evolution is favourable in several days to several weeks and prognosis is favourable, although disorders of moderate intensity may rather often persist, in the form of positional vertigo, sometimes paroxysmal, or disorders of equilibrium on abrupt movement. Careful history-taking and clinical examination, routine evaluation of the vestibular-cochlear apparatus and follow-up of the patient during the first days can eliminate the possibility of vascular cerebellar syndrome, which would require emergency imaging and possibly recuperation by surgery. The aetiology of vestibular neuronitis remains mysterious: inflammatory, viral, vascular? Sedatives acting on the vestibular system should be given for only a very limited time; they inhibit the mechanism of central compensation, which is on the contrary favoured by early vestibular function and rehabilitation.
前庭神经炎是一种前庭器官的急性疾病，表现为突然发作的眩晕，无明显病因，且无听觉或神经症状。从临床和冷热刺激试验来看，其特征为单侧外周前庭功能缺损。病情在数天至数周内好转，预后良好，不过中等强度的紊乱可能相当频繁地持续存在，表现为位置性眩晕，有时为阵发性，或在突然运动时出现平衡障碍。仔细的病史采集和临床检查、前庭蜗器的常规评估以及在最初几天对患者的随访，可排除血管性小脑综合征的可能性，血管性小脑综合征需要紧急成像检查，可能还需要手术恢复。前庭神经炎的病因仍然不明：是炎症性、病毒性还是血管性？作用于前庭系统的镇静剂仅应在非常有限的时间内使用；它们会抑制中枢代偿机制，而早期前庭功能和康复则有利于中枢代偿机制。
