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Treatment of Acute Vestibular Neuronitis With Glucocorticoids

Karlberg, Mikael L.-Å.; Magnusson, Måns

doi: 10.1097/MAO.0b013e3182267e24
Vestibular Disorders
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Objective: To report the effects of glucocorticoid treatment of acute vestibular neuronitis on recovery of vestibular function and length of hospital stay.

Study Design: Prospective, consecutive case series compared with historic controls.

Setting: Secondary referral academic hospital.

Patients: Patients with acute vestibular neuronitis. One group treated with glucocorticoids within 3 days after symptom onset (n = 33) and 2 historic untreated control groups (n = 41 and n = 67).

Interventions: Oral prednisolone 50 mg/d for 5 days with tapering of doses for the next 5 days, alternatively with intravenous betamethasone 8 mg on the first 1 to 2 days if nauseated.

Main Outcome Measures: Extent of unilateral vestibular paresis (%) in the caloric test at presentation and at 12 months of follow-up. Length of hospital stay (days).

Results: The initial vestibular paresis value did not differ between the treatment group and the control group. At follow-up, the treatment group showed a lower value (22.8% versus 47.2%, p = 0.0003) and greater improvement (53.4% versus 35.6%, p = 0.002). At follow-up, 70% of the treatment group had a normal caloric test result compared to only 34% of the control group. The mean hospital stay of the treatment group was significantly shorter than that of the control group (1.8 versus 3.0 d, p = 0.001).

Conclusion: Glucocorticoids administered within 3 days after onset of vestibular neuronitis improves long-time recovery of vestibular function and reduces length of hospital stay.

Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Skåne University Hospital - Lund, Lund University, Lund, Sweden

Address correspondence and reprint requests to Mikael L.-Å. Karlberg, M.D., Ph.D., Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Skåne University Hospital - Lund, Lund University, SE-221 85 Lund, Sweden; E-mail: mikael.karlberg@skane.se

© 2011 Otology & Neurotology, Inc.