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Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.

Batuecas-Caletrío, A; Yañez-Gonzalez, R; Sanchez-Blanco, C; Pérez, PB; González-Sanchez, E; Sanchez, LAG; Kaski, D; (2015) Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy. J Neurol , 262 (11) pp. 2578-2582. 10.1007/s00415-015-7918-x. Green open access

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Abstract

Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV.

Type: Article
Title: Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00415-015-7918-x
Publisher version: http://dx.doi.org/10.1007/s00415-015-7918-x
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Acute unilateral vestibulopathy, Glucocorticoid, Steroid, Symptom recovery, Vertigo, Vestibular neuronitis, Adult, Aged, Dizziness, Female, Glucocorticoids, Humans, Male, Methylprednisolone, Middle Aged, Outcome Assessment (Health Care), Recovery of Function, Retrospective Studies, Vestibular Neuronitis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1553261
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