title: Predictors of development of chronic vestibular insufficiency after vestibular neuritis.
abstract: OBJECTIVE
  To evaluate the role of clinical parameters, MRI and ocular VEMP (oVEMP) and cervical VEMP (cVEMP) as predictors of development of chronic vestibular insufficiency after vestibular neuritis.
  
  
  METHODS
  Twenty-six patients with vestibular neuritis were included: 15 patients (58%) showed complete clinical recovery, and 11 patients (41%) were diagnosed with the syndrome of chronic vestibular insufficiency. Clinical parameters (vomiting, nystagmus, postural stability, and nausea) were assessed at diagnosis. MRI was performed within 3 months and VEMP within 6 days and at 1 year after the initial presentation. The amplitude asymmetry ratio (AR) was calculated using the following formula: AR=((healthy side-affected side)/(healthy side+affected side) × 100).
  
  
  RESULTS
  Of all studied parameters, only chronic white matter supratentorial lesions present on brain MRI negatively correlated with clinical recovery (Phi coefficient=-0.637, p=0.001). The logistic regression analysis showed that positive brain MRI and older age reduced odds for clinical recovery. There was no correlation between clinical recovery and oVEMP AR recovery between groups (p=0.781). Seven patients showed improvement, and 19 showed worsening on oVEMP AR after a 1-year follow-up. Statistical regression model for predicting the outcome of clinical recovery using asymmetry score recovery, as an independent variable, was not statistically significant.
  
  
  CONCLUSIONS
  Older age and chronic white matter lesions on brain MRI are positive predictors of development of chronic vestibular insufficiency after vestibular neuritis. VEMPs are not useful in predicting the development of chronic vestibular insufficiency.
authors.affiliation: Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Adamec
authors.affiliation: Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Krbot Skorić
authors.affiliation: Department of Radiology, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: David
authors.initials: D
authors.lastname: Ozretić
authors.affiliation: Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia. Electronic address: mhabek@mef.hr.
authors.forename: Mario
authors.initials: M
authors.lastname: Habek
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012044:Regression Analysis; D058585:Vestibular Evoked Myogenic Potentials; D014725:Vestibular Nerve / Q000503:physiopathology*; D020338:Vestibular Neuronitis / Q000503:physiopathology*; D066127:White Matter / Q000473:pathology
keywords: Age; Cervical vestibular evoked myogenic potentials; Chronic vestibular insufficiency; MRI; Ocular vestibular evoked myogenic potentials; Vestibular neuritis