Affiliations: Department of Neurology, Royal Prince Alfred Hospital,
Camperdown, Sydney, NSW, Australia | Present address: Department of Neurology, Zürich
University Hospital, Zürich, Switzerland | School of Psychology, University of Sydney, Sydney,
NSW, Australia
Note: [] Corresponding author: Prof. G. M. Halmagyi, Department of
Neurology, Royal Prince Alfred Hospital, Camperdown NSW 2050, Australia. Tel.:
+61 2 9515 8820; Fax: +61 2 9515 8347; E-mail: michael@icn.usyd.edu.au
Abstract: Purpose: To review the extent and mechanism of the recovery of
vestibular function after sudden, isolated, spontaneous, unilateral loss of
most or all peripheral vestibular function – usually called acute vestibular
neuritis. Methods: Critical review of published literature and personal
experience. Results: The symptoms and signs of acute vestibular neuritis
are vertigo, vomiting, nystagmus with ipsiversive slow-phases, ipsiversive
lateropulsion and ocular tilt reaction (the static symptoms) and impairment of
vestibulo-ocular reflexes from the ipsilesional semicircular canals on
impulsive testing (the dynamic symptoms). Peripheral vestibular function might
not improve and while static symptoms invariably resolve, albeit often not
totally, dynamic symptoms only improve slightly if at all. Conclusions: The persistent loss of balance that some patients experience after acute
vestibular neuritis can be due to inadequate central compensation or to
incomplete peripheral recovery and vestibular rehabilitation has a role in the
treatment of both.
