Vestibular neuritis: recurrence and incidence of secondary benign paroxysmal positional vertigo.

CONCLUSIONS: Recurrence of vestibular neuritis (VN) is a rare event in long-term follow-up. The incidence of benign paroxysmal positional vertigo (BPPV) in VN patients represents a quite common outcome. To our knowledge, this study represents the only long-term longitudinal study on recurrence of VN and incidence of secondary BPPV in VN.

OBJECTIVES: To study a large number of VN patients longitudinally to identify the recurrence rate of VN and incidence of BPPV, other peripheral vestibular disorders, sudden hearing loss or Bell's palsy.

METHODS: This prospective cohort study assessed a VN patient-based clinic population. All patients received a complete bedside clinical examination and caloric irrigation.

RESULTS: Long-term (range 4-6 years, mean 4.9 years) longitudinal follow-up examination of 51 VN patients demonstrated a low recurrence rate (1/51 patients, 2.0%). With recurrence, VN affected the same ear after 6 months and caused less severe symptoms. BPPV appears to be more frequent (5/51 patients, 9.8%) in VN patients than in the general population, consistently affecting the posterior canal of the same ear. BPPV occurrence after VN predominantly affects VN patients who did not fully recover from the disease. Moreover, BPPV after VN appears to be more difficult to treat than idiopathic BPPV.