Vibration- and hyperventilation-induced nystagmus in patients with Ramsay Hunt syndrome with vertigo

The aims of this study were to compare vibration-induced nystagmus (VIN) and hyperventilation-induced nystagmus (HVIN) findings in patients with Ramsay Hunt syndrome with vertigo (RHS-V), sudden sensorineural hearing loss with vertigo (SSNHL-V), and vestibular neuritis (VN) during the acute stage and to address the possible lesion sites of vestibular deficit in RHS-V.

Case series with chart review.

Tertiary referral center.

We conducted a retrospective case series study in 27 patients with SSNHL-V, 104 patients with VN, and 17 patients with RHS-V and evaluated the findings of VIN and HVIN tests.

An abnormal VIN was observed in 91% of the patients with VN, 89% of those with SSNHL-V, and 94% of those with RHS-V, and the prevalence of abnormal VIN was not significantly different (P = .436). An abnormal HVIN was observed in 51% of the patients with VN, 22% of those with SSNHL-V, and 59% of those with RHS-V. While the prevalence of an abnormal HVIN was significantly different between SSNHL-V and VN groups (P = .007) and between SSNHL-V and RHS-V groups (P = .014), that between VN and RHS-V groups did not show a significant difference (P = .547).

Since the results of HVIN in RHS-V patients were more similar to those in VN patients than those in SSNHL-V patients, a lesioned site may be more likely within the vestibular nerve than the inner ear as a cause for vestibular deficit in patients with RHS-V who show caloric canal paresis of 25% or greater.