Evidence for a viral neuropathy in recurrent vertigo.
The concept that reactivation of latent neurotropic viruses (i.e. Herpesviridae group) in the vestibular ganglion is responsible for recurrent vestibulopathies is presented. A similar histopathologic degeneration of vestibular ganglion cells in vestibular neuronitis (VN), Ménière's disease and benign paroxysmal positional vertigo is presented to support this concept. The clinical response (relief of vertigo) to the administration of antiviral medication in these syndromes provides practical evidence of a viral neuropathy in patients with recurrent vertigo. Relief of vertigo after this treatment was 90% in VN, Ménière's disease and VN. The relief of positional vertigo (benign paroxysmal positional vertigo) was 66%.
Gacek
Richard R
RR
Department of Otolaryngology-Head and Neck Surgery, University of Massachusetts Medical School, Worcester, MA 01655, USA. GacekR@ummhc.org
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014717:Vertigo / Q000503:physiopathology / Q000821:virology*; D014724:Vestibular Function Tests; D014725:Vestibular Nerve / Q000503:physiopathology / Q000821:virology; D020338:Vestibular Neuronitis / Q000473:pathology / Q000821:virology*