Initial Degree of Spontaneous Nystagmus Affects the Length of Hospitalization of Patients With Vestibular Neuritis.

OBJECTIVE

To assess factors predicting vestibular neuritis (VN) prognosis at an early stage.

STUDY

DESIGN

Retrospective chart review.

SETTING

University hospital.

PATIENTS: Sixty-five patients with VN, between 2014 and 2018.

INTERVENTIONS: Bithermal caloric test, rotatory chair test, subjective visual horizontal and vertical, cervical visual myogenic evoked potential test, and visual head impulse test (vHIT).

MAIN OUTCOME MEASURES: Hospitalization duration.

RESULTS

The mean hospitalization duration was 4.6 ± 1.4 days. Mean caloric weakness was 65.5 ± 20.6%. For the vHIT, gain in both anterior and horizontal semicircular canal (SCC) was statistically significantly different between the lesion and intact sides (p < 0.001). Backward conditional regression analysis revealed that a higher degree of spontaneous nystagmus (SN) (EXP[B] = 1.104, 95% confidence interval [CI] = 1.012-1.204, p = 0.026), and a lower caloric paresis (CP) value (EXP(B) = 1.033, 95% CI = 1.000-1.075, p = 0.047) were associated with 5 days or more of hospitalization. The cut-off value of SN was 12.05 degrees/s for increased hospital stay. Four weeks after discharge from hospital, five patients (8.9%) had persistent SN, and 19 (33.9%) and 28 (50.0%) had a positive HIT and nystagmus during head-shaking, respectively. Patients with persistent nystagmus at 1 month had more severe initial SN (p < 0.05).

CONCLUSION

Only the degree of SN at the initial evaluation affected both the hospitalization period and the bed-side examination results at 1 month after discharge in patients with VN.