Vestibular vertigo. A form of polyneuritis?

K. K. Adour, M. A. Sprague and R. L. Hilsinger Jr

Vestibular vertigo traditionally has been considered to be of viral origin and some forms (acute vestibular neuronitis, acute labyrinthitis, acute vertigo) may be manifestations of a viral cranial polyneuritis. To test this hypothesis, otoneurologic signs and serum complement-fixation titers to herpes simplex and herpes zoster were determined in 16 patients with acute vertigo during their attack and several weeks later. One hundred unselected patients seen for nonotoneurologic problems served as control subjects. In addition to vestibular nerve abnormality, all patients with vertigo had some form of cranial nerve abnormality that cleared within four weeks of onset. These transient acute cranial nerve findings in patients with vestibular vertigo support the concept of inflammatory polyneuritis, and preliminary studies indicate that an anti-inflammatory agent such as prednisone may be the preferred treatment.