European Archives of Oto-Rhino-Laryngology

, Volume 272, Issue 11, pp 3277–3281 | Cite as

A 1-year follow-up study with C-VEMPs, O-VEMPs and video head impulse testing in vestibular neuritis

  • Giuseppe MagliuloEmail author
  • Giannicola Iannella
  • Silvia Gagliardi
  • Massimo Re


The aim of this paper was to evaluate prospectively, in a group of patients affected by VN, a diagnostic protocol employing C-VEMPs, O-VEMPs and vHIT together. The diagnosis of vestibular neurolabyrinthitis was based on the clinical history, absence of associated auditory or neurological symptoms, and a neuro-otological examination with an evaluation of lateral semicircular canal function using the Fitzgerald–Hallpike caloric vestibular test and ice test. Our series revealed an incidence of 55 % of superior and inferior vestibular neurolabyrinthitis, 40 % of superior vestibular neurolabyrinthitis and 5 % of inferior vestibular neurolabyrinthitis. These data, however, comprised different degrees of vestibular involvement considering the evaluation of each single vestibular end-organ with potential different prognosis. Four patients had only deficits of the horizontal and superior semicircular canals or their ampullary nerves. The implementation of C-VEMPs, O-VEMPs and vHIT in a vestibular diagnostic protocol has made possible to observe patients with ampullary VN, unidentifiable with other types of vestibular exams. The effect of age seems to have some impact on the recovery. When recovery firstly involves the utricular and saccular nerves and subsequently the ampullary nerves, it may be reasonable to expect a more favorable and successful outcome.


Vestibular neurolabyrinthitis C-VEMPs O-VEMPs vHIT 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Magliulo G, Gagliardi M, Appiani GC, D’Amico R (2003) Preservation of the saccular nerve and of the vestibular evoked myogenic potential during vestibular schwannoma surgery. Otol Neurotol 24:308–311CrossRefPubMedGoogle Scholar
  2. 2.
    Aw ST, Fetter M, Cremer PD, Karlberg M, Halmagyi GM (2001) Individual semicircular canal function in superior and inferior vestibular neuritis. Neurology 11(57):768–774CrossRefGoogle Scholar
  3. 3.
    Ulmer E, Bernard-Demanze L, Lacour M (2011) Statistical study of normal canal deficit variation range. Measurement using the head impulse video system. Eur Ann Otorhinolaryngol Head Neck Dis 128:278–282CrossRefPubMedGoogle Scholar
  4. 4.
    Govender S, Rosengren SM, Colebatch JG (2011) Vestibular neuritis has selective effects on air- and bone-conducted cervical and ocular vestibular evoked myogenic potentials. Clin Neurophysiol 122:1246–1255CrossRefPubMedGoogle Scholar
  5. 5.
    Shin BS, Oh SY, Kim JS, Kim TW, Seo MW, Lee H, Park YA (2012) Cervical and ocular vestibular-evoked myogenic potentials in acute vestibular neuritis. Clin Neurophysiol 123:369–375 Epub 19 Jul 2011CrossRefPubMedGoogle Scholar
  6. 6.
    Magliulo G, Gagliardi S, Appiani MC, Iannella G, Gagliardi M (2012) Selective vestibular neurolabyrinthitis of the lateral and superior semicircular canals and ampullary nerves. Ann Otol Rhinol Laryngol 121:640–644CrossRefPubMedGoogle Scholar
  7. 7.
    Walther LE, Blödow A (2013) Ocular vestibular evoked myogenic potential to air conducted sound stimulation and video head impulse test in acute vestibular neuritis. Otol Neurotol 34:1084–1089CrossRefPubMedGoogle Scholar
  8. 8.
    Magliulo G, Gagliardi S, Appiani MC, Iannella G, Re M (2014) Vestibular Neurolabyrinthitis: a follow-up study with cervical and ocular vestibular evoked myogenic potentials and the video head impulse test. Ann Otol Rhinol Laryngol 123:162–173CrossRefPubMedGoogle Scholar
  9. 9.
    Kim HA, Hong JH, Lee H, Yi HA, Lee SR, Jang BC, Ahn BH, Baloh RW (2008) Otolith dysfunction in vestibular neuritis. Neurology 70:449–453CrossRefPubMedGoogle Scholar
  10. 10.
    Ulmer E, Chays A (2005) Curthoys and Halmagyi head impulse test: an analytical device. Ann Otolaryngol Chir Cervicofac 122:84–90CrossRefPubMedGoogle Scholar
  11. 11.
    Leveque M, Seiderman L, Tran H, Langagne T, Ulmer E, Chays A (2010) Vestibular function outcomes after vestibular neurectomy in Meniere disease:can vestibular neurectomy provide complete vestibular deafferentation? Auris Nasus Larynx 37:308–313CrossRefPubMedGoogle Scholar
  12. 12.
    Magliulo G, Cuiuli G, Gagliardi M, Ciniglio-Appiani G, D’Amico R (2004) Vestibular evoked myogenic potentials and glycerol testing. Laryngoscope 114:338–343CrossRefPubMedGoogle Scholar
  13. 13.
    Magliulo G, Cianfrone G, Gagliardi M, Cuiuli G, D’Amico R (2004) Vestibular evoked myogenic potentials and distortion-product otoacoustic emissions combined with glycerol testing in endolymphatic hydrops: their value in early diagnosis. Ann Otol Rhinol Laryngol 113:1000–1005CrossRefPubMedGoogle Scholar
  14. 14.
    Magliulo G, Parrotto D, Cuiuli G, Alla FR, Gagliardi M (2007) Preservation of vestibular evoked myogenic potentials with modified translabyrinthine approach. Arch Otolaryngol Head Neck Surg 133:720–723CrossRefPubMedGoogle Scholar
  15. 15.
    Welgampola MS, Carey JP (2010) Waiting for the evidence: VEMP testing and the ability to differentiate utricular versus saccular function. Otolaryngol Head Neck Surg 143:281–283PubMedCentralCrossRefPubMedGoogle Scholar
  16. 16.
    Zellhuber S, Mahringer A, Rambold HA (2014) Relation of video-head-impulse test and caloric irrigation: a study on the recovery in unilateral vestibular neuritis. Eur Arch Otorhinolaryngol 271:2375–2383CrossRefPubMedGoogle Scholar
  17. 17.
    Murofushi T, Iwasaki S, Ushio M (2006) Recovery of vestibular-evoked myogenic potentials after vertigo attack due to vestibular neuritis. Acta Otolaryngol 126:364–367CrossRefPubMedGoogle Scholar
  18. 18.
    Halmagyi GM, Karlberg M, Curthoys IS, Todd MJ (2002) Inferior vestibular neuritis. Ann N Y Acad Sci 956:306–313CrossRefPubMedGoogle Scholar
  19. 19.
    Schmid-Priscoveanu A, Bohmer A, Obzim H, Straumann D (2001) Caloric and search-coil head-impulse testing in patients after vestibular neuritis. JARO 2:72–78PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    D’Onofrio F (2013) Vertical eye movements during horizontal head impulse test: a new clinical sign of superior vestibular neuritis. Acta Otorhinolaryngol Ital 33:418–424PubMedCentralPubMedGoogle Scholar
  21. 21.
    Manzari L, Burgess AM, MacDougall HG, Curthoys IS (2013) Vestibular function after vestibular neuritis. Int J Audiol. 52:713–718CrossRefPubMedGoogle Scholar
  22. 22.
    Bartolomeo M, Biboulet R, Pierre G, Mondain M, Uziel A, Venail F (2014) Value of the video head impulse test in assessing vestibular deficits following vestibular neuritis. Eur Arch Otorhinolaryngol 271:681–688CrossRefPubMedGoogle Scholar
  23. 23.
    Eleftheriadou A, Skalidi N, Velegrakis GA (2012) Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Otorhinolaryngol 269:2309–2316CrossRefPubMedGoogle Scholar
  24. 24.
    Han BI, Song HS, Kim JS (2011) Vestibular rehabilitation therapy: review of indications mechanisms, and key exercises. J Clin Neurol 7:184–196PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Giuseppe Magliulo
    • 1
    Email author
  • Giannicola Iannella
    • 1
  • Silvia Gagliardi
    • 1
  • Massimo Re
    • 1
    • 2
  1. 1.“Organi di Senso” DepartmentUniversity “La Sapienza”RomeItaly
  2. 2.Department of Clinical SciencesPolytechnic University of MarcheRomeItaly

Personalised recommendations