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Title: [Vestibular function features and prognosis of vestibular neuritis in children].
Author: Liu B, Li B, Zhang L, Jiang SM, Chen M, Liu W, Liu HH, Zhang J.
Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2018 Dec 07; 53(12):899-903. PubMed ID: 30585000.
Abstract:
Objective: To investigate the clinical characteristics, prognosis and affected branches of vestibular neuritis in children. Methods: Twenty-five patients with vestibular neuritis in ENT department, Beijing Children's Hospital, from October 2015 to October 2016, were collected. All patients were 4-14 (mean 9.8) years old including 17 boys and 8 girls. The clinical manifestations history, pure tone audiometry (PTA), vestibular function tests were done for each patient. We also took the blood samples for pathogenic virus in order to analyze the premorbid risk factors. Results: Rotational vertigo were complained by all presents. There were 17 cases (68%, 17/25) with nausea and vomiting and 19 cases (76%, 19/25) with balance dysfunction. There were 12 cases (60%, 12/20) with positive results in 20 blood samples for virology, among which 6 cases of influenza B virus and 4 cases of herpes simplex virus, 1 case of cytomegalovirus and 1 case of coxsackie were identified. The results of PTA were normal. Bithermal caloric test was abnormal in 22 cases (88%, 22/25). The ocular vestibular-evoked myogenic potential (oVEMP) in 12 cases (48%, 12/25) and cervical vestibular-evoked myogenic potential (cVEMP) in 5 cases (20%, 5/25) were abnormal. The bithermal caloric test along with oVEMP and cVEMP in 4 cases (16%, 4/25) were abnormal. The bithermal caloric test and oVEMP in 7 cases (28%, 7/25) were abnormal. The bithermal caloric test in 11 cases (44%, 11/25) were abnormal. The oVEMP in 1 cases (4%, 1/25) was abnormal. The cVEMP in 1 cases (4%, 1/25) was abnormal. All patients recovered well, but the time varied. The symptoms of 21 patients were complete recovery within 1 month. 3 patients were complete recovery within 2 months (aged 8 - 14 years old). One patient was complete recovery within 6 months (aged 13 years old). Conclusion: Rotary vertigo is most commonly in children with vestibular neuritis, accompany with imbalance and vomiting. The vestibular neuritis in children might be related with upper respiratory tract infection. Audiometry test is normal. Because of the bithermal caloric test and oVEMP are obvious abnormality, therefore it is speculated that the superior vestibular nerve may most commonly be affected. The younger patients with vestibular neuritis recovered more quickly than the older children. 目的： 探讨前庭神经炎患儿的前庭功能特点和前庭神经受累情况及其相关病因学特性和预后。 方法： 分析2015年10月至2016年10月北京儿童医院25例诊断为前庭神经炎患儿的临床资料，其中男17例，女8例，年龄4～14岁，中位年龄9.8岁。总结患儿的临床表现、听力学和前庭功能检查结果特点，通过病原学检查分析其发病前相关风险因素及预后。 结果： 25例患儿均有旋转性眩晕症状，其中伴恶心、呕吐17例(68%，17/25)，伴平衡障碍19例(76%，19/25)。20例患儿行病原学检测，12例阳性(60%，12/20)，其中流感病毒B型6例、单纯疱疹病毒4例、巨细胞病毒1例、柯萨奇病毒1例。听力学检查：25例患儿纯音测听或游戏测听听阈均正常。前庭功能检查：冷热试验、眼性前庭诱发肌源性电位(oVEMP)、颈性前庭诱发肌源性电位(cVEMP)异常者分别为22例(88%，22/25)、12例(48%，12/25)和5例(20%，5/25)，其中冷热试验＋oVEMP＋cVEMP均异常者4例(16%，4/25)，冷热试验＋oVEMP异常者7例(28%，7/25)，仅冷热试验异常者11例(44%，11/25)，仅oVEMP异常者1例(4%，1/25)，仅cVEMP异常者1例(4%，1/25)。治疗后随访：1个月内眩晕、平衡障碍等症状及前庭功能检查完全恢复者21例，2个月内恢复者3例(年龄8～14岁)，6个月恢复者1例(年龄13.9岁)。 结论： 儿童前庭神经炎的临床症状以旋转性眩晕为主，多伴有呕吐和平衡障碍；其发病可能与上呼吸道病毒感染有关。患儿听力正常，前庭检查中冷热试验、oVEMP的异常率较高，推测病变主要累及前庭上神经。小龄患儿前庭功能恢复快，大龄患儿前庭功能恢复较慢。.

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