title: Glucocorticoids improve acute dizziness symptoms following acute unilateral vestibulopathy.
abstract: Acute unilateral vestibulopathy (AUV) is characterized by acute vertigo, nausea, and imbalance without neurological deficits or auditory symptomatology. Here, we explore the effect of glucocorticoid treatment on the degree of canal paresis in patients with AUV, and critically, establish its relationship with dizziness symptom recovery. We recruited consecutive patients who were retrospectively assigned to one of the two groups according to whether they received glucocorticoid treatment (n = 32) or not (n = 44). All patients underwent pure-tone audiometry, bithermal caloric testing, MRI brain imaging, and were asked to complete a dizziness handicap inventory on admission to hospital and just prior to hospital discharge. In the treatment group, the canal paresis at discharge was significantly lower than in the control group (mean ± SD % 38.04 ± 21.57 versus 82.79 ± 21.51, p < 0.001). We also observed a significant reduction in the intensity of nystagmus in patients receiving glucocorticoid treatment compared to the non-treatment group (p = 0.03). DHI test score was significantly lower at discharge in the treatment group (mean ± SD % 23.15 ± 12.40 versus 64.07 ± 12.87, p < 0.001), as was the length of hospital stay (2.18 ± 1.5 days versus 3.6 ± 1.7 days, p = 0.002). Glucocorticoid treatment leads to acute symptomatic improvement, with a reduced hospital stay and reduction in the intensity of acute nystagmus. Our findings suggest that glucocorticoids may accelerate vestibular compensation via a restoration of peripheral vestibular function, and therefore has important clinical implications for the treatment of AUV.
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Batuecas-Caletrío
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Yañez-Gonzalez
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Sanchez-Blanco
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Pedro Blanco
authors.initials: PB
authors.lastname: Pérez
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: González-Sanchez
authors.affiliation: Unidad de Otoneurología, Servicio de ORL y PCF, IBSAL, University Hospital of Salamanca, Salamanca, Spain.
authors.forename: Luis Alberto Guardado
authors.initials: LA
authors.lastname: Sanchez
authors.affiliation: Department of Brain Sciences, Imperial College London, Charing Cross Hospital, London, UK. d.kaski@imperial.ac.uk.
authors.forename: Diego
authors.initials: D
authors.lastname: Kaski
mesh_terms: D000328:Adult; D000368:Aged; D004244:Dizziness / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D012189:Retrospective Studies; D020338:Vestibular Neuronitis / Q000150:complications / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Acute unilateral vestibulopathy; Glucocorticoid; Steroid; Symptom recovery; Vertigo; Vestibular neuronitis