Retrospective Study on the Outcome After Acute Unilateral Peripheral Vestibulopathy in 197 Patients

Objective: Acute unilateral peripheral vestibulopathy is a common and debilitating condition with a variable functional outcome. Currently, no consensus about treatment is available. This study aimed at developing a management algorithm based on the retrospective review of our 16-year acute unilateral peripheral vestibulopathy database and a literature review. Methods: This study involves retrospective case series study of 197 patients presenting with acute unilateral peripheral vestibulopathy in a secondary referral center between 2002 and 2017 with the investigation of the effect of demographics and treatment interventions on 3 outcome parameters, being peripheral vestibular recuperation, central compensation, and symptomatic relief. A review of the current literature was conducted. Results: Every extra percent of initial labyrinthic predominance on caloric testing above the limit of 25% resulted in a 3%, 6%, and 2% lower chance of achieving, respectively, complete peripheral recuperation, central compensation, and symptomatic relief. Every extra year of age resulted in a 3% lower chance of getting completely symptom-free. Performing home exercises gave 3.65 times higher probability of reaching symmetric peripheral vestibular function. Conclusion: A management algorithm for acute unilateral peripheral vestibulopathy was developed with the major keys to success being the early start, high intensity, and customization of vestibular rehabilitation therapy. Higher age and degree of initial hypofunction seem to be negative prognostic factors.