The Effect of Intravenous Dexamethasone on the Nausea Accompanying Vestibular Neuritis: A Preliminary Study.

Abstract

PURPOSE:

We undertook a preliminary assessment of the efficacy of administering intravenous dexamethasone (DEX) for relieving the nausea and dizziness accompanying vestibular neuritis (VN).

METHODS:

Between November 2013 and October 2014, 26 patients with VN were prospectively enrolled in this study. The patients were randomly assigned to treatment with a combination of 20 mg/d of intravenous metoclopramide, 100 mg of oral dimenhydrinate, and 5 mg/d of intravenous DEX or 20 mg/d of intravenous metoclopramide, 100 mg of oral dimenhydrinate, and intravenous normal saline as a placebo therapy. Patients' subjective assessments of the severity of their nausea and dizziness were recorded using a visual analog scale on the day of admission and 2 days, 3 days, 1 month, and 3 months thereafter. Bedside examinations consisted of spontaneous nystagmus (SPN) assessment, the head shaking nystagmus test, and the head impulse test, which were performed at every follow-up visit.

FINDINGS:

The severity of nausea and dizziness was significantly reduced over time (both P < 0.05). However, there was no significant effect of DEX injection on the severity of nausea or dizziness (P > 0.05). The presence of SPN was solely associated with nausea (hazard ratio = 3.34; 95% CI, 1.85-6.02).

IMPLICATIONS:

The administration of intravenous DEX did not relieve nausea or dizziness any better than a placebo treatment. However, further research is required to confirm whether there is a dose-dependent effect of DEX on the control of nausea or dizziness in VN.

• Authors: Ji Chan Kim, Wang Woon Cha, Dong Sik Chang, Ho Yun Lee
• Journal: Clinical therapeutics (Clin Ther) Vol. 37 Issue 11 Pg. 2536-42 (Nov 01 2015) ISSN: 1879-114X [Electronic] United States
• PMID: 26475420 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

Chemical References

• Dexamethasone
• Metoclopramide

Topics

• Administration, Intravenous
• Adult
• Aged
• Aged, 80 and over
• Dexamethasone (administration & dosage)
• Dizziness (drug therapy, etiology)
• Female
• Humans
• Male
• Metoclopramide (administration & dosage)
• Middle Aged
• Nausea (drug therapy, etiology)
• Prospective Studies
• Vestibular Neuronitis (drug therapy)