valacyclovir and Vertigo

This clinical report is presented to describe how results of vestibular function testing were considered along with other medical history to develop a management plan that was ultimately successful.. The patient underwent audio-vestibular assessment including comprehensive audiogram, videonystagmography, cervical vestibular evoked myogenic potential, and postural stability testing.. Results from initial testing were most consistent with uncompensated peripheral vestibular dysfunction affecting the right superior vestibular nerve. These results, considered along with history and symptoms, supported vestibular neuritis. After a second vertigo event, we became concerned about the potential temporal association between the patient's rheumatoid arthritis treatment and symptom onset. It is established that treatment for rheumatoid arthritis can exacerbate latent viral issues, but this has not specifically been reported for vestibular neuritis. There are reports in the literature in which patients successfully used viral suppressant medication to decrease viral activity while they were able to continue benefiting from immunosuppressive therapy. We hypothesized that, if the current patient's vestibular neuritis events were related to her treatment for rheumatoid arthritis, she may also benefit from use of viral suppressant medication while continuing her otherwise successful immunosuppressive intervention.. Patients treated with biologic disease-modifying antirheumatic drugs are more susceptible to viral issues, and this may include vestibular neuritis. For the current case, identifying this possibility and recommending viral suppressant medication allowed her to continue with successful treatment of rheumatoid arthritis while avoiding additional vertigo events.

Topics: Acyclovir; Antirheumatic Agents; Arthritis, Rheumatoid; Biological Products; Female; Humans; Middle Aged; Prognosis; Recurrence; Risk Assessment; Severity of Illness Index; Treatment Outcome; Valacyclovir; Valine; Vertigo; Vestibular Function Tests; Vestibular Neuronitis

Topics: Aged, 80 and over; Antiviral Agents; Diagnosis, Differential; Female; Herpes Zoster Oticus; Humans; Prednisolone; Valacyclovir; Vertigo

Discussion of a rare case of angioleiomyoma of the internal auditory canal.. Thirteen-year-old female patient with a 1-year history of progressive hearing loss.. Middle cranial fossa approach providing complete surgical extirpation.. Surgical pathology.. Radiography and history suggestive of vestibular schwannoma; pathology revealed angioleiomyoma.. Angioleiomyoma is a rare lesion of the internal auditory canal that has many similar clinical and radiographic features of a vestibular schwannoma. There are no previous reports of this tumor occurring within the internal auditory canal in this age group.

Topics: Acyclovir; Adolescent; Angiomyoma; Anti-Inflammatory Agents; Antiviral Agents; Cranial Fossa, Middle; Ear Neoplasms; Ear, Inner; Facial Nerve; Facial Nerve Diseases; Female; Hearing Loss, Sudden; Humans; Magnetic Resonance Imaging; Postoperative Complications; Prednisone; Tomography, X-Ray Computed; Valacyclovir; Valine; Vertigo; Vestibular Nerve