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Visual Dependency and Dizziness after Vestibular Neuritis

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Title: Visual Dependency and Dizziness after Vestibular Neuritis
Authors: Cousins, S
Cutfield, NJ
Kaski, D
Palla, A
Seemungal, BM
Golding, JF
Staab, JP
Bronstein, AM
Item Type: Journal Article
Abstract: Symptomatic recovery after acute vestibular neuritis (VN) is variable, with around 50% of patients reporting long term vestibular symptoms; hence, it is essential to identify factors related to poor clinical outcome. Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36–80) had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03). Asymptomatic patients and those with minor residual symptoms did not differ from controls. Visual dependence was associated with high levels of persistent vestibular symptoms after acute VN. Over-reliance on visual information for spatial orientation is one characteristic of poorly recovered vestibular neuritis patients. The finding may be clinically useful given that visual dependence may be modified through rehabilitation desensitization techniques.
Issue Date: 18-Sep-2014
Date of Acceptance: 23-Jul-2014
URI: http://hdl.handle.net/10044/1/49034
DOI: https://dx.doi.org/10.1371/journal.pone.0105426
ISSN: 1932-6203
Publisher: Public Library of Science
Journal / Book Title: PLOS One
Volume: 9
Issue: 9
Copyright Statement: © 2014 Cousins et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: Medical Research Council (MRC)
The Academy of Medical Sciences
Funder's Grant Number: G0600183
N/A
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
CHRONIC SUBJECTIVE DIZZINESS
PHOBIC POSTURAL VERTIGO
TERM-FOLLOW-UP
GUINEA-PIG
COMPENSATION
RECOVERY
SUBSTITUTION
ANXIETY
ORIENTATION
NEURONITIS
Adult
Aged
Dizziness
Female
Humans
Male
Middle Aged
Postural Balance
Spatial Processing
Treatment Outcome
Vertigo
Vestibular Function Tests
Vestibular Nerve
Vestibular Neuronitis
Vestibule, Labyrinth
Vision, Ocular
Young Adult
General Science & Technology
MD Multidisciplinary
Publication Status: Published
Article Number: ARTN e105426
Appears in Collections:Department of Medicine
Faculty of Medicine



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