The use of antiserotonin drugs in the nucleoreticular vestibular syndrome: preliminary observations.

Vestibular neuronitis was described in 1949 and 1952 by Dix and Hallpike. Two groups of patients were described, those with sudden seizures and sensations of blackout (since identified as having vestibular neuritis) and a second group with symptoms of disequilibrium and feelings of top-heaviness or imbalance. The pathology was believed to be central to the inner ear. Arslan labeled these groups as having nucleoreticular vestibular syndrome. Using a suprathreshold stapedial reflex test, Bosatra localized the pathophysiology in the brainstem, an area rich in serotonergic neurons. This author has used antiserotonergic drugs, with success, in treating patients having the symptoms identified by Dix and Hallpike in their second group (which now should be labeled nucleoreticular vestibular syndrome), properly identified as a brainstem affliction. This study describes the characteristics of this disorder, the methods of diagnosis and treatment, and the outcomes in two groups of patients studied. The study concluded that antiserotonin drugs, specifically affecting 5-hydroxytryptamine2, should be considered in the management of nucleoreticular vestibular syndrome.