COVID-19-ASSOCIATED VESTIBULAR NEURITIS: A CASE REPORT

Abstract

Objective: The aim of this work is to present a rare case of vestibular neuritis induced by a COVID-19 non-severe infection, which had an unusual refractory response to symptomatic measures. Case Description: 53-year-old female, reported to the neurological department with acute vertigo, nausea, vomiting and a very severe gait impairment, after six weeks of a COVID-19 non-severe infection. Some of these episodes lasted up to 2 to 3 hours, and all happened spontaneously and were not precipitated by head movements. She denied symptoms as tinnitus, hearing loss, loss of consciousness, veering to one side when walking. She also denied any prior history of vertigo or recent trauma. The initial neurologic and otoscopic exam, out of seizures, were normal. Romberg maneuver and positioning maneuvers like Dix Hallpike, and Semont were negative. There were no abnormalities with the Magnetic Resonance Imaging (MRI), Computer Tomography (CT), audiometry, and blood exam. Vectonistagmography showed a preponderance of the right vestibular nerve during the caloric test. There was no improvement with symptomatic drugs, minimal improvement with benzodiazepine and vestibular rehabilitation and she still reports vertigo. Conclusions: We should be aware that vestibular neuritis can be associated with COVID-19 and may be more refractory to symptomatic measures than the vestibular neuritis we are used to.