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Steroids for Acute Vestibular Neuronitis-the Earlier the Treatment, the Better the Outcome?

Sjögren, Julia LU ; Magnusson, Måns LU ; Tjernström, Fredrik LU and Karlberg, Mikael LU (2019) In Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 40(3). p.372-374
Abstract

OBJECTIVE: To present findings that suggest steroid treatment within 24 hours of onset of vestibular neuronitis results in better restitution of vestibular function than treatment between 25 and 72 hours. PATIENTS: Thirty-three consecutive patients (17 men, 16 women, mean age 57 yr, range 17-85 yr) with acute vestibular neuronitis and treated with steroids within 72 hours after symptom onset. Patients were divided into two groups depending on if they were treated within the first 24 hours or not. INTERVENTIONS: Oral prednisolone 50 mg/d for 5 days with tapering of doses for the next 5 days, or combined with initial intravenous betamethasone 8 mg the first 1 to 2 days if the patient was nauseous. MAIN OUTCOME MEASURES: Proportion of... (More)

OBJECTIVE: To present findings that suggest steroid treatment within 24 hours of onset of vestibular neuronitis results in better restitution of vestibular function than treatment between 25 and 72 hours. PATIENTS: Thirty-three consecutive patients (17 men, 16 women, mean age 57 yr, range 17-85 yr) with acute vestibular neuronitis and treated with steroids within 72 hours after symptom onset. Patients were divided into two groups depending on if they were treated within the first 24 hours or not. INTERVENTIONS: Oral prednisolone 50 mg/d for 5 days with tapering of doses for the next 5 days, or combined with initial intravenous betamethasone 8 mg the first 1 to 2 days if the patient was nauseous. MAIN OUTCOME MEASURES: Proportion of patients with normal caloric test result (canal paresis value < 32%) at follow-up after 3 or 12 months. RESULTS: All 9 patients (100%) treated within 24 hours from onset of vestibular neuronitis had normal caloric test results at follow-up after 3 months, as compared with 14 of 24 (58%) of the patients treated between 25 and 72 hours (p < 0,05, Fisher's exact test). CONCLUSIONS: The timing of steroid treatment of vestibular neuronitis may be of importance for subsequent vestibular restitution, and hence, for both time to recovery and late symptoms according to the literature.

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organization
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publication status
published
subject
in
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
volume
40
issue
3
pages
3 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85061238893
  • pmid:30681432
ISSN
1537-4505
DOI
10.1097/MAO.0000000000002106
language
English
LU publication?
yes
id
696ed6aa-48e9-4472-beec-7999f05a65e0
date added to LUP
2019-02-18 14:28:20
date last changed
2020-02-19 05:20:46
@article{696ed6aa-48e9-4472-beec-7999f05a65e0,
  abstract     = {<p>OBJECTIVE: To present findings that suggest steroid treatment within 24 hours of onset of vestibular neuronitis results in better restitution of vestibular function than treatment between 25 and 72 hours. PATIENTS: Thirty-three consecutive patients (17 men, 16 women, mean age 57 yr, range 17-85 yr) with acute vestibular neuronitis and treated with steroids within 72 hours after symptom onset. Patients were divided into two groups depending on if they were treated within the first 24 hours or not. INTERVENTIONS: Oral prednisolone 50 mg/d for 5 days with tapering of doses for the next 5 days, or combined with initial intravenous betamethasone 8 mg the first 1 to 2 days if the patient was nauseous. MAIN OUTCOME MEASURES: Proportion of patients with normal caloric test result (canal paresis value &lt; 32%) at follow-up after 3 or 12 months. RESULTS: All 9 patients (100%) treated within 24 hours from onset of vestibular neuronitis had normal caloric test results at follow-up after 3 months, as compared with 14 of 24 (58%) of the patients treated between 25 and 72 hours (p &lt; 0,05, Fisher's exact test). CONCLUSIONS: The timing of steroid treatment of vestibular neuronitis may be of importance for subsequent vestibular restitution, and hence, for both time to recovery and late symptoms according to the literature.</p>},
  author       = {Sjögren, Julia and Magnusson, Måns and Tjernström, Fredrik and Karlberg, Mikael},
  issn         = {1537-4505},
  language     = {eng},
  number       = {3},
  pages        = {372--374},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology},
  title        = {Steroids for Acute Vestibular Neuronitis-the Earlier the Treatment, the Better the Outcome?},
  url          = {http://dx.doi.org/10.1097/MAO.0000000000002106},
  doi          = {10.1097/MAO.0000000000002106},
  volume       = {40},
  year         = {2019},
}