Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial.JAMA Otolaryngol Head Neck Surg. 2014 May; 140(5):434-40.JO
Abstract
IMPORTANCE The management of patients with unilateral acute vestibular neuritis (VN) has not been established to date.
OBJECTIVE
To compare the use of vestibular exercises vs corticosteroid therapy in the recovery of patients with acute VN. DESIGN, SETTING, AND PARTICIPANTS Prospective, single-blind, randomized clinical trial at a primary referral center. Among all patients with acute vertigo, those having VN were eligible for inclusion in the study. INTERVENTIONS Forty patients with acute VN were randomly assigned to perform vestibular exercises or to receive corticosteroid therapy. After a baseline examination, follow-up evaluations were performed at 1, 6, and 12 months. MAIN OUTCOMES AND MEASURES Efficacy outcomes included clinical, canal, and otolith recovery. Scores on the European Evaluation of Vertigo Scale and the Dizziness Handicap Inventory were used for the evaluation of clinical recovery. Findings of caloric irrigation and vestibular evoked myogenic potentials indicated canal and otolith improvement, respectively.RESULTS
Comparing the 2 treatment groups, no statistically significant differences were found in clinical, canal, or otolith recovery. At the 6-month examination, the number of patients with complete disease resolution in the corticosteroids group was significantly higher than that in the vestibular exercises group. However, at the end of the follow-up period, 45%(9 of 20) of patients in the vestibular exercises group and 50% (10 of 20) of patients in the corticosteroids group had complete disease resolution (P > .05).CONCLUSIONS
AND RELEVANCE Treating patients who have acute VN with vestibular exercises seems equivalently effective as treating them with corticosteroid therapy in clinical, caloric, and otolith recovery. Corticosteroid therapy seems to enhance earlier complete acute VN resolution, with no added benefit in the long-term prognosis.Links
MeSH
Pub Type(s)
Journal Article
Randomized Controlled Trial
Language
eng
PubMed ID
24604142
Clinical Trial Links
Citation
Goudakos, John K., et al. "Corticosteroids and Vestibular Exercises in Vestibular Neuritis. Single-blind Randomized Clinical Trial." JAMA Otolaryngology-- Head & Neck Surgery, vol. 140, no. 5, 2014, pp. 434-40.
Goudakos JK, Markou KD, Psillas G, et al. Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2014;140(5):434-40.
Goudakos, J. K., Markou, K. D., Psillas, G., Vital, V., & Tsaligopoulos, M. (2014). Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial. JAMA Otolaryngology-- Head & Neck Surgery, 140(5), 434-40.
Goudakos JK, et al. Corticosteroids and Vestibular Exercises in Vestibular Neuritis. Single-blind Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2014;140(5):434-40. PubMed PMID: 24604142.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Corticosteroids and vestibular exercises in vestibular neuritis. Single-blind randomized clinical trial.
AU - Goudakos,John K,
AU - Markou,Konstantinos D,
AU - Psillas,George,
AU - Vital,Victor,
AU - Tsaligopoulos,Miltiadis,
PY - 2014/3/8/entrez
PY - 2014/3/8/pubmed
PY - 2014/7/9/medline
SP - 434
EP - 40
JF - JAMA otolaryngology-- head & neck surgery
JO - JAMA Otolaryngol Head Neck Surg
VL - 140
IS - 5
N2 - IMPORTANCE The management of patients with unilateral acute vestibular neuritis (VN) has not been established to date. OBJECTIVE To compare the use of vestibular exercises vs corticosteroid therapy in the recovery of patients with acute VN. DESIGN, SETTING, AND PARTICIPANTS Prospective, single-blind, randomized clinical trial at a primary referral center. Among all patients with acute vertigo, those having VN were eligible for inclusion in the study. INTERVENTIONS Forty patients with acute VN were randomly assigned to perform vestibular exercises or to receive corticosteroid therapy. After a baseline examination, follow-up evaluations were performed at 1, 6, and 12 months. MAIN OUTCOMES AND MEASURES Efficacy outcomes included clinical, canal, and otolith recovery. Scores on the European Evaluation of Vertigo Scale and the Dizziness Handicap Inventory were used for the evaluation of clinical recovery. Findings of caloric irrigation and vestibular evoked myogenic potentials indicated canal and otolith improvement, respectively. RESULTS Comparing the 2 treatment groups, no statistically significant differences were found in clinical, canal, or otolith recovery. At the 6-month examination, the number of patients with complete disease resolution in the corticosteroids group was significantly higher than that in the vestibular exercises group. However, at the end of the follow-up period, 45%(9 of 20) of patients in the vestibular exercises group and 50% (10 of 20) of patients in the corticosteroids group had complete disease resolution (P > .05). CONCLUSIONS AND RELEVANCE Treating patients who have acute VN with vestibular exercises seems equivalently effective as treating them with corticosteroid therapy in clinical, caloric, and otolith recovery. Corticosteroid therapy seems to enhance earlier complete acute VN resolution, with no added benefit in the long-term prognosis.
SN - 2168-619X
UR - https://www.unboundmedicine.com/medline/citation/24604142/Corticosteroids_and_vestibular_exercises_in_vestibular_neuritis__Single_blind_randomized_clinical_trial_
L2 - https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/10.1001/jamaoto.2014.48
DB - PRIME
DP - Unbound Medicine
ER -