Objective evaluation of the effect of flunarizine on vestibular neuritis

To determine whether vestibular autorotation tests (VAT) would show significant differences in vestibular oculomotor reflex (VOR) parameters in vertiginous patients before and after treatment with flunarizine.

Prospective study in a tertiary referral academic center.

Twenty-three patients (10 men, 13 women, mean age 45.57 years, mean length of disease 99.48 days, mean treatment 38.61 days), with vertigo due to vestibular neuritis, underwent VAT testing before and after treatment with 5 mg of flunarizine daily.

The parameter improvement value (IV) resulted from subtracting posttreatment from pretreatment VAT numerical values. Regarding subjective improvement, 3 patients (13%) said they had none, 5 (21.7%) expressed moderate progress, 9 (39.1) considered the results satisfactory, and 6 (26%) became asymptomatic. The VAT results gave high positive IV for horizontal restriction, low positive for horizontal and vertical gains and horizontal asymmetry, and negative IV for horizontal phase and vertical restriction. Regarding the individual frequencies, horizontal and vertical gains improved in all the frequencies tested except one. The horizontal phase improved at low frequencies (2.0 and 2.3 Hz) and deteriorated from 2.7 to 3.9 Hz. Vertical and horizontal restriction showed both improvement and deterioration. Horizontal asymmetry displayed improvement from -0.01 at 2.0 Hz to 0.50 at 5.9 Hz, deteriorating from -0.41 at 9.0 Hz.

Flunarizine is useful in the treatment of vertigo caused by vestibular neuritis. VAT is a valid instrument for the objective and quantitative evaluation of the vestibular-oculomotor reflexes.