Symptoms and their Time Course in the Patient of Acute Peripheral Vestibular Lesion

Abstract

Severe vertigo, violent spontaneous nystagmus and body ataxia usually appears when the peripheral vestibular organ is rapidly damaged unilaterally. These symptoms due to acute vestibular asymmetry may gradually be eliminated with different time courses depending upon the symptom. Spontaneous recovery from the eye and body disequilibria is considered to occur by way of the central compensation mechanism.Training therapy of repeated vestibular stimulation was administered to four cases of acute peripheral vestibular disturbance with the expectation of acceleration of the patients gaining the central compensation. The rationale for this therapy lies in the fact that the post-rotatory nystagmus, which is assumed to be a sign produced by transient vestibular asymmetry, be can suppressed by repeated rotatory stimulations.The following results were obtained after a relatively long clinical observation.All pathological symptoms disappeared 7 weeks after the onset in a case of a 5-year-old boy with serious labyrinthitis.In cases of 60-year-old and 74-year-old patients with vestibular neuronitis, some of the symptoms, especially discoordination between the head and the eyes, persisted for a long time until they were finally eliminated. In both cases, dizzy sensation provoked by head movement and positioning nystagmus to the intact side appeared sporadically until one year and seven months after the onset whenever the patients felt fatigued in their daily lives. Marked body ataxia without visual fixation persisted for a long time in a case of streptomycin intoxication, although it was slightly decreased 2 years and 5 months after the onset.The authors hope to confirm the effectiveness of this training therapy for patients the with peripheral vestibular disturbance in further studies.