Immunological Examination of Cerebrospinal Fluid in Patients with Vestibular Neuronitis

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The cerebrospinal fluid (CSF) and serum of four patients with vestibular neuronitis were studied immunologically. Our patients were one male and three females aged 28 to 55 years. They had no caloric response at the initial test, 2 to 18 days after the onset, and were observed for over one month. All CSF samples, obtained by lumbar puncture, were examined for total protein, albumin, IgG, cell count and several virus antibodies (herpes simplex 1, 2, varicella-zoster, cytomegalo, EB, rubeola, parainfluenza types 1-4, influenza A, B, rubella and Japanese encephalitis viruses).1) In all four cases, CSF total protein was slightly increased without rise of cell counts during the clinical course.2) The CSF/serum albumin Index (CSF×103/serum albumin concentration ratio) and IgG Index [(CSF/serum IgG)/(CSF/serum albumin)] were within the normal range and there was no specific change in their relationship during the clinical course.3) Herpes simplex virus type 1 IgG antibody titer in paired sera rose in one of the four, but in the CSF there was no change.4) Herpes simplex virus type 1 IgG antibody titer in the CSF rose in another case starting 26 days after the onset and remained elevated even after three months. At the same time, the serum titer was also elevated, but there was no specific change.5) These results support the view that vestibular neuronitis is closely related to herpes simplex viral infection.
耳鼻咽喉科臨床学会の論文