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Functional Loss After Meningitis-Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

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@article{5395be54c23a40849855d2e9bee212c8,
title = "Functional Loss After Meningitis-Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss",
abstract = "Introduction: The inner ear vestibular system is essential to balance function. Although hearing loss is well-described and quite common following meningitis, the literature evaluating vestibular function following meningitis is very limited. In particular, information on results of contemporary vestibular function tests, e.g., the video head impulse test (VHIT), is scarce. Using contemporary vestibular function tests, this study examines the vestibular function of patients with profound hearing loss (HL) after meningitis. Methods: Review of the literature and retrospective controlled study. Patients: Twenty-one consecutive patients with profound HL after meningitis (cochlear implant candidates) matched with 20 patients with profound HL of unknown etiology and examined during the period 2013-2018. Outcome Measure: Vestibular function loss, as evaluated with VHIT vestibulo-ocular reflex (VOR) gain, eye movement saccades, and cervical vestibular-evoked myogenic potentials (cVEMPs). The results of these tests were correlated to inner ear imaging findings (MRI/CT) and the level of hearing loss. Results: Mean VHIT gain was 0.48 in the meningitis group compared to 0.86 in the control group (p < 0.01). Saccades were present in 21 ears (62%) in the meningitis group compared to six ears (15%) among the controls (p < 0.01). cVEMP responses were present on five ears (18%) in the meningitis group and 25 ears (66%) in the control group (p < 0.01). Discussion: Postmeningitic hearing loss is associated with poor vestibular function, as evaluated by VHIT, saccades, and cVEMP. Loss of vestibular function correlates with the degree of hearing loss and inner ear imaging findings, although not in all cases. Vestibular function should be examined in patients surviving meningitis with hearing loss in order to individualize rehabilitation and improve balance outcome.",
keywords = "cochlear fibrosis, cochlear implant, hearing loss, neuroinfection, vestibular, vestibulopathy",
author = "Niels West and Hjalte Sass and Mads Klokker and Per Cay{\'e}-Thomasen",
note = "Copyright {\textcopyright} 2020 West, Sass, Klokker and Cay{\'e}-Thomasen.",
year = "2020",
month = jul,
day = "30",
doi = "10.3389/fneur.2020.00681",
language = "English",
volume = "11",
pages = "681",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Research Foundation",

}

RIS

TY - JOUR

T1 - Functional Loss After Meningitis-Evaluation of Vestibular Function in Patients With Postmeningitic Hearing Loss

AU - West, Niels

AU - Sass, Hjalte

AU - Klokker, Mads

AU - Cayé-Thomasen, Per

N1 - Copyright © 2020 West, Sass, Klokker and Cayé-Thomasen.

PY - 2020/7/30

Y1 - 2020/7/30

N2 - Introduction: The inner ear vestibular system is essential to balance function. Although hearing loss is well-described and quite common following meningitis, the literature evaluating vestibular function following meningitis is very limited. In particular, information on results of contemporary vestibular function tests, e.g., the video head impulse test (VHIT), is scarce. Using contemporary vestibular function tests, this study examines the vestibular function of patients with profound hearing loss (HL) after meningitis. Methods: Review of the literature and retrospective controlled study. Patients: Twenty-one consecutive patients with profound HL after meningitis (cochlear implant candidates) matched with 20 patients with profound HL of unknown etiology and examined during the period 2013-2018. Outcome Measure: Vestibular function loss, as evaluated with VHIT vestibulo-ocular reflex (VOR) gain, eye movement saccades, and cervical vestibular-evoked myogenic potentials (cVEMPs). The results of these tests were correlated to inner ear imaging findings (MRI/CT) and the level of hearing loss. Results: Mean VHIT gain was 0.48 in the meningitis group compared to 0.86 in the control group (p < 0.01). Saccades were present in 21 ears (62%) in the meningitis group compared to six ears (15%) among the controls (p < 0.01). cVEMP responses were present on five ears (18%) in the meningitis group and 25 ears (66%) in the control group (p < 0.01). Discussion: Postmeningitic hearing loss is associated with poor vestibular function, as evaluated by VHIT, saccades, and cVEMP. Loss of vestibular function correlates with the degree of hearing loss and inner ear imaging findings, although not in all cases. Vestibular function should be examined in patients surviving meningitis with hearing loss in order to individualize rehabilitation and improve balance outcome.

AB - Introduction: The inner ear vestibular system is essential to balance function. Although hearing loss is well-described and quite common following meningitis, the literature evaluating vestibular function following meningitis is very limited. In particular, information on results of contemporary vestibular function tests, e.g., the video head impulse test (VHIT), is scarce. Using contemporary vestibular function tests, this study examines the vestibular function of patients with profound hearing loss (HL) after meningitis. Methods: Review of the literature and retrospective controlled study. Patients: Twenty-one consecutive patients with profound HL after meningitis (cochlear implant candidates) matched with 20 patients with profound HL of unknown etiology and examined during the period 2013-2018. Outcome Measure: Vestibular function loss, as evaluated with VHIT vestibulo-ocular reflex (VOR) gain, eye movement saccades, and cervical vestibular-evoked myogenic potentials (cVEMPs). The results of these tests were correlated to inner ear imaging findings (MRI/CT) and the level of hearing loss. Results: Mean VHIT gain was 0.48 in the meningitis group compared to 0.86 in the control group (p < 0.01). Saccades were present in 21 ears (62%) in the meningitis group compared to six ears (15%) among the controls (p < 0.01). cVEMP responses were present on five ears (18%) in the meningitis group and 25 ears (66%) in the control group (p < 0.01). Discussion: Postmeningitic hearing loss is associated with poor vestibular function, as evaluated by VHIT, saccades, and cVEMP. Loss of vestibular function correlates with the degree of hearing loss and inner ear imaging findings, although not in all cases. Vestibular function should be examined in patients surviving meningitis with hearing loss in order to individualize rehabilitation and improve balance outcome.

KW - cochlear fibrosis

KW - cochlear implant

KW - hearing loss

KW - neuroinfection

KW - vestibular

KW - vestibulopathy

UR - http://www.scopus.com/inward/record.url?scp=85089435228&partnerID=8YFLogxK

U2 - 10.3389/fneur.2020.00681

DO - 10.3389/fneur.2020.00681

M3 - Journal article

C2 - 32849181

VL - 11

SP - 681

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 681

ER -

ID: 60788902