2. 前庭神経炎

抄録

It has been shown that the superior division of the vestibular nerve is preferentially affected while the inferior division is spared in many cases of vestibular neuritis. Long-lasting horizontal rotational nystagmus, a positive result in the horizontal head impulse test (HIT), and a positive result of the caloric test are characteristics of vestibular neuritis. However, some other cases have been reported in which only the inferior vestibular nerve region is affected while the superior vestibular nerve region is spared. It should be noted that the examination findings may vary depending on the site of the lesion. The In regard to the?? clinical course of vestibular neuritis, abnormality in the HIT and subjective visual vertical (SVV) are often predictors of? early recovery. However, recovery of canal paresis in the caloric test is slower and the recovery rate in the caloric test is lower than that in the HIT and the SVV. Although some studies have indicated statistically significant beneficial effects of corticosteroid therapy on the outcomes of vestibular neuritis, it must be recognized that there is currently insufficient evidence to support the administration of corticosteroids to patients with vestibular neuritis. Taking into consideration the risk of adverse effects of steroid use, recommendations or decisions to treat patients with vestibular neuritis with corticosteroids should be discussed with each patient. To control the severe vertigo, nausea and vomiting in patients with vestibular neuritis in the acute stage, administration of vestibular suppressants and anti-emetics may be effective. These medications should be withdrawn as soon as possible because vestibular suppression may inhibit the process by which the brain compensates for vestibular imbalance. We consider that vestibular rehabilitation is effective for patients with vestibular neuritis who show persistent chronic disability for more than several weeks after the onset.