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. 2017 Mar 22;4(5):340-346.
doi: 10.1002/acn3.386. eCollection 2017 May.

Predictors of clinical recovery from vestibular neuritis: a prospective study

Sian Cousins  1 , Diego Kaski  1 , Nicholas Cutfield  2 , Qadeer Arshad  1 , Hena Ahmad  1 , Michael A Gresty  1 , Barry M Seemungal  1 , John Golding  3 , Adolfo M Bronstein  1
Affiliations

Predictors of clinical recovery from vestibular neuritis: a prospective study

Sian Cousins et al. Ann Clin Transl Neurol. .

Abstract

We sought to identify predictors of symptomatic recovery in vestibular neuritis. Forty VN patients were prospectively studied in the acute phase (median = 2 days) and 32 in the recovery phase (median = 10 weeks) with vestibulo-ocular reflex, vestibular-perceptual, and visual dependence tests and psychological questionnaires. Clinical outcome was Dizziness Handicap Inventory score at recovery phase. Acute visual dependency and autonomic arousal predicted outcome. Worse recovery was associated with a combination of increased visual dependence, autonomic arousal, anxiety/depression, and fear of bodily sensations, but not with vestibular variables. Findings highlight the importance of early identification of abnormal visual dependency and concurrent anxiety.

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Figures

Figure 1
Figure 1
(A) Laptop‐based rod‐and‐disk test to measure visual dependency, showing a subject viewing the screen through a field‐restricting cone. Subjects carried out the test in a darkened room. (B) Laptop screen showing the randomly placed dots around the vertical line (rod) that subjects have to set up to vertical with a roller mouse (details in5). The task is carried out both with the background dots stationary and with dots rotating around the line of sight clockwise and counterclockwise (arrow) at 30 deg/sec. Visually induced rod tilt was used as a measure of visual dependence, calculated as the mean absolute rod tilt (in degrees) during disk rotation minus rod tilt values in the static condition.4 (C) Symptomatic recovery as measured by the DHI at the acute, recovery (10 week), and long‐term recovery (10 month) phases. DHI values are normalized from 0 to 4. Error bars are standard error of the mean. (D) Caloric canal paresis recovery. Most of the clinical (DHI) and caloric recovery takes place during the first 10 weeks. Despite this, individual clinical recovery is predicted by visual dependence rather than caloric improvement (see text). DHI, dizziness handicap inventory.
Figure 2
Figure 2
Factor analysis summarizing measures that correlate significantly (before adjustment) with symptomatic recovery (DHI at 10 weeks). Component 1 accounts for 59% of variance within the data set, and component 2 accounts for 12% of variance. For clarity those variables that load strongly (>0.7)25 on each component are only shown.
See this image and copyright information in PMC

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