Static Otolith Signals Reflect Clinical Course in Acute Vestibular Neuritis.

OBJECTIVES

To investigate how static and dynamic utricular functions differentially correlate with dizziness symptoms and quality of life (QoL) recovery in patients with acute vestibular neuritis (VN).

DESIGN

Prospective observational study with 1-week and 1-month follow-up assessments.

SETTING

Tertiary referral centre.

PARTICIPANTS

Twenty-six patients diagnosed with acute VN were enrolled and evaluated at baseline, 1 week and 1 month after symptom onset.

MAIN OUTCOME MEASURES: Static utricular function was assessed using subjective visual vertical (SVV), and dynamic function via ocular vestibular-evoked myogenic potentials (oVEMP). Dizziness symptoms and QoL were evaluated using the Dizziness Handicap Inventory (DHI), Visual Analogue Scale (VAS) and the EQ-5D-5L questionnaire.

RESULTS

Patients with normalised SVV tilt at 1 week showed significantly greater improvement in DHI scores compared to those with persistent abnormal SVV (p = 0.046). By 1 month, these patients demonstrated further significant improvement in both DHI (p = 0.012) and EQ-5D-5L (p = 0.035) scores. Furthermore, early improvement in SVV tilt correlated significantly with DHI improvement at 1 week (p = 0.048, Spearman's rho = 0.392). In contrast, dynamic utricular function as measured by oVEMP did not correlate with clinical recovery at any time point.

CONCLUSION

In acute VN, static utricular function correlates with early symptom relief and QoL recovery, whereas dynamic function does not. These findings suggest that central adaptive mechanisms may act more selectively on static utricular signals or recover dynamic pathways more rapidly.