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Mikael Karlberg, MD, PhD; Mårten Annertz, MD, PhD; Måns Magnusson, MD, PhD

Arch Otolaryngol Head Neck Surg. 2004;130:229-232.

Sudden idiopathic unilateral loss of vestibular function without other signs or symptoms is called acute vestibular neuritis. It has been suggested that reactivation of human herpes simplex virus 1 could cause vestibular neuritis, Bell palsy, and sudden unilateral hearing loss. Enhancement of the facial nerve on gadolinium-enhanced magnetic resonance imaging (MRI) is a common finding in Bell palsy, but enhancement of the vestibular nerve has never been reported in acute vestibular neuritis. We present 2 consecutive cases of acute vestibular neuritis where high-field-strength MRI (3.0 T) with high-dose (0.3 mmol/kg of body weight) gadolinium–pentetic acid showed isolated enhancement of the vestibular nerve on the affected side only. These findings support the hypothesis of a viral and inflammatory cause of acute vestibular neuritis and might have implications for its treatment.

From the Departments of Otorhinolaryngology–Head and Neck Surgery (Drs Karlberg and Magnusson) and Diagnostic Radiology (Dr Annertz), Lund University Hospital, Lund, Sweden. The authors have no relevant financial interest in this article.

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