by Juliette Dufour
For October 2022, we have selected: Gerb et al, Vestibular syndromes after COVID-19 vaccination: A prospective cohort study. European Journal of Neurology, 2022, DOI: 10.1111/ene.15546.
Dizziness and vertigo are common symptoms after COVID-19 vaccination and few data are available on this subject. The aim of the study was to evaluate objective central or peripheral vestibular function in patients with dizziness, vertigo, and postural symptoms that started or worsened after COVID-19 vaccination.
Therefore, our authors of the month conducted a prospective cohort study at a tertiary referral centre for patients with vertigo, dizziness, and balance disorders. Of 4,137 patients who presented between January 2021 and April 2022 at the German Center for Vertigo and Balance Disorders, they identified 72 patients (mean age = 47 years) with enduring vestibular symptoms following COVID-19 vaccination. All of the patients underwent neurological and neuro-otological workup with a bithermal caloric test, video head-impulse test, orthoptics, and audiometry.
The results were as follows:
- Symptom onset was within the first four weeks post vaccination.
- The most prevalent diagnoses were:
o Somatoform vestibular disorders (34.7%)
o Vestibular migraine (19.4%)
o Overlap syndromes of both (18.1%)
These disorders were significantly overrepresented compared to the pre-pandemic control cohort.
- Nine patients presented with benign paroxysmal positional vertigo, three with acute unilateral vestibulopathy, and seven with different entities (vestibular paroxysmia, Ménière disease, polyneuropathy, ocular muscular paresis).
- None of the patients with PPPD/functional dizziness showed new peripheral or central vestibular deficits
The authors of our paper of the month conclude that there was no evidence that COVID-19 vaccination induces enduring peripheral or central vestibular deficits more frequently than expected from spontaneous incidence. The predominant causes of prolonged vestibular complaints were somatoform vestibular disorders and vestibular migraine, possibly triggered or aggravated by stress-related circumstances due to the COVID-19 pandemic or vaccination.
The management of patients should include education about the unimpaired vestibular functioning and the overall favorable prognosis, especially to prevent chronification and long-term sick leave with a socioeconomic burden.