scotsman9
12-05-2004, 08:11 PM
I was reading through the recent article from NEJM posted by John and thought it would be worthwhile to list the criteria the researchers used for diagnosing VN. After reading this it doesn't look like it's what I had (started thinking maybe it was) given the very strong onset. Does this fit your situation CL or anyone else?
I know this is all a bit technical but perhaps some of you can relate to one or two of these and may help to confirm a VN attack.
N Engl J Med, Jul 22 2004, 351(4) p354-61
The diagnosis of vestibular neuritis was based on four criteria. There was a history of the acute or subacute (ie. within minutes to hours) onset of severe, prolonged rotatory vertigo, nausea, and postural imbalance. On clinical examination, there was a horizontal spontaneous nystagmus with a rotational component toward the unaffected ear (fast phase) without evidence of a central vestibular lesion, and the head-thrust test (performed by turning the head of the patient rapidly to the right and left to provoke compensatory eye movements) showed an ipsilateral (the same side) deficit of the horizontal semicircular canal.
Caloric irrigation showed hyporesponsiveness or lack of responsiveness of the horizontal canal of the affected ear. (The maximal slow-phase velocity during caloric irrigation with water at 30°C and 44°C should be less than three degrees per second on the affected side, and the asymmetry between the two sides should be more than 25 percent as measured with the use of Jongkees’s formula for vestibular paresis (paralysis)).
Finally, there was a perceived displacement of verticality and the eyes rotated toward the affected ear without showing vertical divergence of one eye above the other.
Scott :cool:
I know this is all a bit technical but perhaps some of you can relate to one or two of these and may help to confirm a VN attack.
N Engl J Med, Jul 22 2004, 351(4) p354-61
The diagnosis of vestibular neuritis was based on four criteria. There was a history of the acute or subacute (ie. within minutes to hours) onset of severe, prolonged rotatory vertigo, nausea, and postural imbalance. On clinical examination, there was a horizontal spontaneous nystagmus with a rotational component toward the unaffected ear (fast phase) without evidence of a central vestibular lesion, and the head-thrust test (performed by turning the head of the patient rapidly to the right and left to provoke compensatory eye movements) showed an ipsilateral (the same side) deficit of the horizontal semicircular canal.
Caloric irrigation showed hyporesponsiveness or lack of responsiveness of the horizontal canal of the affected ear. (The maximal slow-phase velocity during caloric irrigation with water at 30°C and 44°C should be less than three degrees per second on the affected side, and the asymmetry between the two sides should be more than 25 percent as measured with the use of Jongkees’s formula for vestibular paresis (paralysis)).
Finally, there was a perceived displacement of verticality and the eyes rotated toward the affected ear without showing vertical divergence of one eye above the other.
Scott :cool: