Postural control in patients after a recent vestibular neuritis with hyperhomocysteinemia

To assess the possible role of hyperhomocysteinemia(HyHcy) in delaying recovery after acute vestibularneuritis. In our retrospective study, 90 subjects wereevaluated within 7 days from the beginning of an acutevertigo. All subjects had high plasma levels of homocysteine(Hcy). 46 patients were treated with homocysteinelowering therapy and betahistine for 1 month, while 44subjects received only betahistine. Subjective symptomswere evaluated with the Dizziness Handicap Inventory(DHI) questionnaire, administered 7 days after the beginningof vertigo and again after 1 month. Moreover, posturalcontrol performed at 1 month’ control was studiedwith static stabilometry in a subgroup of 21 non-treated and20 treated patients. DHI total score decreased significantlymore in the subgroup of subjects treated with homocysteinelowering therapy. Moreover, posturographic data weresignificantly increased in non-treated compared with treatedsubjects. Our data support the possibility of a role ofHyHcy in preventing recovery after a recent vestibularneuritis. A microvascular disorder or the neurotoxic effectof HyHcy have been considered as possible causal factors.Although not conclusive, our data are not inconsistent withthe hypothesis of a poorer adaptation in patients withuntreated HyHcy.