Vestibular evoked myogenic potentials and health-related quality of life in patients with vestibular neuritis.

摘要

OBJECTIVE: To evaluate the usefulness of vestibular evoked myogenic potentials (VEMPs) in subjects with vestibular neuritis (VN) and to determine the impact of the disease in health-related quality of life (HRQoL). STUDY DESIGN: Case series. SETTING: Tertiary referral center. PATIENTS: Fifty patients with VN (episode of sudden onset of prolonged vertigo [>24 h] associated with peripheral vestibular hypofunction, imbalance in absence of hearing loss, or other neurologic symptoms). INTERVENTION: VEMPs were measured in 41 patients by using an air-conducted 500 Hz tone burst. HRQoL was evaluated in all cases by the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and Dizziness Handicap Inventory Short Form (DHI-S) instruments, after the acute episode was resolved. MAIN OUTCOME MEASURE: Latencies P1 or N1 peaks, corrected amplitude or the absence of response, for VEMPs; scores obtained in SF-36 and DHI-S instruments. RESULTS: VEMPs showed abnormal results in 21 (51%) of 41 cases, with an increase in ipsilateral latencies for P1 and N1 peaks being the most common finding. Three patients (7%) had ipsilateral abnormal VEMP response with normal caloric response, indicating isolated involvement of inferior vestibular nerve. The total score obtained for the DHI-S was 14.76 +/- 11.07 (range, 0-34/40), suggesting a variable impact among patients with VN. For the SF-36, scores in men with VN were worse than their age-matched controls for all dimensions, except for mental health. However, women only showed lower scores for general health and social function. CONCLUSION: Abnormal VEMP responses demonstrate the involvement of the inferior vestibular nerve in half of the patients with VN. Moreover, VN has a moderate impact in HRQoL, and it is perceived more disabling by men than women.