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Updated: Aug 21, 2025

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Is Vestibular Neuropathy Rather a Neuritis?

Sophia M Haeussler1, Samira I Zabaneh2, Miriam Stegemann3

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|November 16, 2022
PubMed
Summary

Vestibular neuritis (VN) may have infectious causes like herpes simplex virus (HSV) and Lyme disease (LD). Testing for these infections can guide specific treatments beyond standard VN care.

Keywords:
head impulse testherpes simplexlyme's diseasevertigo diagnosisvestibular dysfunctionvestibular neuritis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Vestibular neuritis (VN) is a common cause of peripheral vestibular neuropathy.
  • Identifying infectious etiologies is crucial for effective VN management.

Purpose of the Study:

  • To investigate potential infectious causes of VN in a large patient cohort.
  • To evaluate the role of neurotropic viruses and Lyme disease in VN.

Main Methods:

  • Retrospective study of 98 VN patients over four years.
  • Clinical examination, functional diagnostics, and assessment of infection parameters.
  • Testing for herpes simplex virus (HSV), cytomegalovirus (CMV), and Lyme disease (LD).

Main Results:

  • 42.85% of VN patients showed signs of infection (elevated leukocytes, CRP, HSV, CMV, or LD).
  • Elevated leukocytes were significantly more common in patients with vestibular loss (p=0.028).
  • Positive serology for HSV IgG (52.8%), HSV IgM (7.5%), and LD IgM (11.3%) was observed.

Conclusions:

  • A significant proportion of VN cases exhibit infectious markers.
  • Testing for HSV and LD, in addition to other neurotropic viruses, is recommended for VN patients.
  • Infectious workup can lead to targeted treatments complementing standard VN therapy.