Patterns of vestibular function in patients with dizziness after COVID-19 vaccination; dual tertiary referral center study

Abstract

Background

Although dizziness is a common symptom after vaccination, the mechanism, and prognosis are not well understood.

Aims/Objectives

This study aimed to investigate patients with dizziness after COVID-19 vaccination by analyzing objective information.

Methods

A retrospective study of patients who visited the outpatient clinics of two institutes with a complaint of dizziness occurring within 72 h after a COVID-19 vaccination.

Results

In most cases, patients experienced only a single event of dizziness, and the subjective symptom was relieved after a few weeks. All patients decreased gain of vestibular ocular reflex (VOR). The vestibular function test results showed signs of central vestibulopathy in some cases. We separated patients into two groups; the direction-fixed nystagmus (DFN) group and the direction-changing nystagmus (DCN) group. All patients showed decreased gain on the rotational chair test (RCT). The DFN group showed an 80% decrease in video head impulse test (vHIT) gain, whereas the DCN group only showed a decrease of 25%. In RCT, 66% of the DFN group showed asymmetry compared to 20% showing asymmetry in the DCN group.

Conclusion and significance

The patients who suffered from dizziness after the COVID-19 vaccination exhibited decreased VOR gain and in some cases signs of central vestibulopathy.

Chinese Abstract

背景：尽管头晕是疫苗接种后的常见症状, 但其机制和预后尚不清楚。

目的：本研究旨在通过分析客观信息, 调查 COVID-19 疫苗接种后出现头晕的患者。

方法：对就诊于两家医院的门诊的患者进行回顾性研究。这些患者在接种 COVID-19 疫苗后 72 小时内主诉发生头晕。

结果：在大多数情况下, 患者仅经历一次头晕事件, 几周后主观症状得到缓解。所有患者的前庭眼反射 (VOR) 增益均降低。前庭功能检查结果显示某些病例中枢性前庭病变的迹象。我们将患者分为两组：方向固定眼球震颤（DFN）组和方向改变眼球震颤（DCN）组。所有患者在旋转椅测试 (RCT) 中均表现出增益下降。 DFN组显示视频头脉冲测试 (vHIT) 增益下降 80%, 而 DCN 组仅显示下降了 25%。在随机对照试验中, DFN 组中66%的患者表现出不对称性, 相比之下在 DCN 组中有20%显示不对称。

结论与意义：接种 COVID-19 疫苗后出现头晕的患者表现出 VOR 增益降低, ​​某些病例表现出中央前庭病变的迹象。

Keywords:

• Covid 19
• vestibulopathy
• vaccination
• dizziness

Ethical approval

All procedures performed in this study were based on the ethical standards and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from individual participants included in the study. The local research ethics committee approved the present study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by grant No. 3420220040 from the Seoul National University Hospital & Invites Biocore Research Fund and supported by a Creative Materials Discovery Program through the National Research Foundation (2019M3D1A1078943) funded by the National Research Foundation of Korea (NRF).