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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.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

24604142

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 -