3D analysis of spontaneous nystagmus in early stage of vestibular neuritis.
OBJECTIVE
The pathological localization of vestibular neuritis is still controversial. Analyses of the spontaneous nystagmus support the temporal bone studies, which indicated the location of the pathology to be in the superior vestibular nerve. However, based on the data from the head impulse testing the pathology is in the vestibular nerve including the inferior branch.


METHODS
Twenty-three patients with vestibular neuritis participated in this study. The spontaneous nystagmus was recorded within 1 week after the onset of the disease. Three-dimensional analysis of the nystagmus was performed using video image analysis system. The rotation axis was calculated and compared to the anatomical axes of the semicircular canals.


RESULTS
The axes of the spontaneous nystagmus in all patients were scattered around the axes of horizontal and anterior canals, especially between the compound axis of anterior and horizontal canals and the axis of horizontal canal. The statistical analysis revealed that in the quite early stage of the disease (day 0-2 of the attack), the spontaneous nystagmus tended to have more torsional eye movements as compared to the less early stage (day 3-6).


CONCLUSIONS
The present study strongly suggests that the pathology of vestibular neuritis is in the superior vestibular nerve branch. Also it can be speculated that at the early stage of this disease, the pathology is in the whole branch of the nerve. Subsequently, the anterior canal branch recovers faster than the horizontal canal branch.
Yagi
T
T
Department of Otolaryngology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan. t.yagi@nms.ac.jp
Koizumi
Yasuo
Y
Sugizaki
Kazuki
K
D000328:Adult; D000368:Aged; D002150:Caloric Tests / Q000379:methods; D004584:Electronystagmography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000175:diagnosis* / Q000503:physiopathology; D012665:Semicircular Canals / Q000294:innervation; D014724:Vestibular Function Tests / Q000379:methods*; D014725:Vestibular Nerve / Q000503:physiopathology*; D020338:Vestibular Neuronitis / Q000175:diagnosis* / Q000503:physiopathology*; D014741:Video Recording