Analysis of features of ocular tilt reaction for patients with vestibular neuritis

Abstract

Objective:To analyze the clinical characteristics of ocular tilt reaction in vestibular neuritis patients and discuss its value to the diagnosis of vestibular neuritis.Method:Thirty-five patients with vestibular neuritis confirmed between January 2016 and March 2018 underwent bedside vestibular function physical examination including nystagmus, head impulse test(HIT),head shaking nystagmus(HSN), ocular tilt reaction(OTR), Romberg sign, Fukuda stepping. All patients underwent head CT scan and brain MRI scan + DWI to exclude bleeding and infarction. Pure tone audiometry and acoustic impedance check to understand the hearing and middle ear pressure.Result:In all the 35 patients with vestibular neuritis, OTR was observed in 29 patients (82.8%); Typical OTR was seen in 5 of 35 patients (14.3%), atypical OTR was seen in 24 of 35 patients (68.5%), static ocular torsion were observed in 4 of 35 patients (11.4%). Ipsiversive skew deviation and head tilt were observed in 20 of 35 patients (57.1%). In 29 cases, the symptoms of patients with OTR disappeared after 1-4 days, with an average of (2.62 ± 0.26) days.Conclusion:As an important index for diagnosis of vestibular neuritis, OTR is often neglected by clinicians, and its positive rate is high, which can be used as a key inspection items of bedside vestibular function physical examination.