Vestibularni neuronitis: patofiziologija, dijagnoza i liječenje [Vestibular neuronitis: pathophysiology, diagnosis and treatment]

Žaper, Dinka and Adamec, Ivan and Gabelić, Tereza and Krbot, Magdalena and Išgum, Velimir and Hajnšek, Sanja and Habek, Mario (2012) Vestibularni neuronitis: patofiziologija, dijagnoza i liječenje [Vestibular neuronitis: pathophysiology, diagnosis and treatment]. Lijec̆nic̆ki vjesnik, 134 (11-12). pp. 340-5. ISSN 0024-3477

[img]
Preview
PDF
Download (364kB) | Preview

Abstract

Vestibular neuritis (VN) is one of the most common causes of peripheral vertigo. Caloric testing has been the traditional gold standard for detecting a peripheral vestibular deficit, but some recently developed bedside tests (head thrust, head heave, head shake and vibration test) were evaluated as a good alternative with similar sensitivity and specificity. These tests have shown both diagnostic value in the short term and prognostic value in the long term, and have availability and ease of use as an advantage. As an addition to clinical examination, vestibular evoked myogenic potentials can differentiate between involvement of superior and inferior branch of the vestibular nerve, but also between peripheral and central lesions. Although glucocorticoids are currently widely used in the treatment of VN, there is a lack of evidence for the validity of their administration. There are a number of high quality clinical trials that suggest vestibular rehabilitation exercises, which are based on the mechanisms of vestibular compensation, in the managment of VN. This review will focus on the latest developments in the pathophysiology, diagnosis and treatment of patients with VN.

Abstract in Croatian

Vestibularni neuritis (VN) jedan je od najčešćih perifernih uzroka vrtoglavice. Kalorimetrijsko ispitivanje vestibularnog organa zlatni je standard u dijagnostici VN-a. Ipak, novija istraživanja ističu praktičnost primjene kliničkih testova koji se izvode uz krevet bolesnika, a usporedivi su s osjetljivosti i specifičnosti u odnosu prema zlatnom standardu. Riječ je o »head thrust«, »head heave«, »head shake« i vibracijskom testu. Osim kalorimetrijskog testiranja kao zlatnog standarda u dijagnostici VN-a, vestibularni evocirani miogeni potencijali (VEMP) mogu razlikovati oštećenje gornje i donje grane vestibularnog živca, ali i periferno od centralnog oštećenja. Unatoč tomu što je u liječenju VN-a već dugo ustaljena primjena glukokortikoida, novija istraživanja opravdanost njihove upotrebe dovode u pitanje, a s druge se strane naglašava važnost fizikalne rehabilitacije. U ovome preglednom članku bit će iznesene najnovije spoznaje o patofiziologiji, dijagnostici i liječenju bolesnika s VN-om.

Item Type: Article
MeSH: Humans ; Vestibular Neuronitis/diagnosis ; Vestibular Neuronitis/physiopathology ; Vestibular Neuronitis/therapy
Departments: Katedra za neurologiju
Depositing User: Marijan Šember
Status: Published
Creators:
CreatorsEmail
Žaper, DinkaUNSPECIFIED
Adamec, IvanUNSPECIFIED
Gabelić, TerezaUNSPECIFIED
Krbot, MagdalenaUNSPECIFIED
Išgum, VelimirUNSPECIFIED
Hajnšek, SanjaUNSPECIFIED
Habek, MarioUNSPECIFIED
Date: November 2012
Date Deposited: 14 Mar 2014 11:03
Last Modified: 14 Mar 2014 11:03
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2075

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year