Prednisone treatment for vestibular neuritis.
OBJECTIVE
To evaluate the value of corticosteroids in the treatment of vestibular neuritis (VN).


METHODS
Prospective controlled randomized.


METHODS
Thirty VN patients, 15 in the study and 15 in the control group, were the subjects of the study. The study group was treated by 1 mg/kg prednisone for 5 days, followed by gradually reduced doses of prednisone for an additional 15 days, and vestibular sedatives for symptomatic relief during the first 5 days after presentation. The control group received a placebo and similar vestibular sedatives. The patients had a baseline evaluation and follow-up examinations after 1, 3, 6, and 12 months. The groups were compared for the presence of symptoms and signs, caloric lateralization on the electronystagmography (ENG), the presence of other pathologic findings in the ENG, and Dizziness Handicap Inventory scores.


RESULTS
No differences were found between the groups in the occurrence of symptoms and signs, degree of caloric lateralization, presence of other ENG pathologic findings, and Dizziness Handicap Inventory scores at the end of the study. Complete resolution was observed in 64% of the study and in 80% of the control group. The study group showed earlier recovery of ENG lateralization at the 1- and 3-month follow-up evaluations and higher rates of complete resolution at the 3- and 6-month follow-up points.


CONCLUSIONS
Prednisone therapy might enhance earlier recovery but does not improve the long-term prognosis of VN. The clinical and laboratory parameters in VN are not correlated, and both are required for complete patient evaluation.
Shupak
Avi
A
Unit of Otoneurology, Carmel and Lin Medical Centers, Haifa, Israel. shupak@internet-zahav.net
Issa
Anthony
A
Golz
Avishay
A
Margalit Kaminer
Braverman
Itzhak
I
D000328:Adult; D000368:Aged; D002936:Cinnarizine / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage*; D011379:Prognosis; D011398:Promethazine / Q000008:administration & dosage; D011446:Prospective Studies; D016896:Treatment Outcome; D020338:Vestibular Neuronitis / Q000188:drug therapy*
D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D002936:Cinnarizine; D011398:Promethazine; D011241:Prednisone