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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
ADAPTATION TO VESTIBOLOPATHIES
Otorinolaringologia 2005 September;55(3):165-7
Compensation in vestibular neuronitis
Casorelli I., Mandalà M., Nuti D.
Dipartimento di Scienze Ortopedico-Riabilitative Radiologiche e Otorinolaringoiatriche Sezione di Otorinolaringoiatria Università degli Studi di Siena, Siena
After a vestibular neuronitis, the majority of patients with functional residual deficit reach a static vestibular compensation. Only in 16% of patients in fact a spontaneous nystagmus after 6 months is detectable. Contrarily vestibular dynamic signs tend to persist probably because mechanisms of adaptation hardly succeed to be effective when we use high velocity stimulus, particularly if the peripheral organ is heavily damaged. Generally patients with a vestibular persistent caloric areflexia show a deficit in vestibule-oculomotor reflex during a rapid rotation of the head or a persistent nystagmus induced by Head Shaking (HSTest). Instead in 50% of patients with residual hyporeflectivity after 6 months we can observe a dynamic compensation.
From the analysis of our data, it appears that the caloric test, though considered a gold standard in detection of peripheral vestibular deficit, can supply missleading negative results, even if this is rare. In our survey, in fact, there are patients that present a normal caloric test after 3 and 6 months of deficit, but an HST pathologic.