Systemic inflammatory markers in vestibular neuritis and BPPV: A single-center retrospective study
Abstract
Aims: This study aimed to compare systemic inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), derived NLR (dNLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), in patients with vestibular neuritis (VN) and benign paroxysmal positional vertigo (BPPV) and to evaluate their potential role in differential diagnosis.
Methods: In this retrospective study, 109 patients diagnosed with VN (n=52) or BPPV (n=57) at Kastamonu Training and Research Hospital were included between January 2024 and December 2024. Demographic characteristics, clinical data, and laboratory parameters (leukocyte, neutrophil, lymphocyte, monocyte, platelet, CRP, and albumin levels) were recorded. NLR, dNLR, MLR, PLR, SII [(platelet × neutrophil)/lymphocyte], and SIRI [(neutrophil × monocyte)/lymphocyte] were calculated.
Results: The two groups were similar regarding age and sex distribution; however, bilateral involvement was significantly more common in the BPPV group (p=0.004). The VN group showed significantly higher leukocyte (p=0.027) and neutrophil (p=0.004) counts and significantly lower albumin levels (p=0.001). Among inflammatory markers, NLR (p=0.012), SII (p=0.023) and SIRI (p=0.035) were found to be significantly higher in VN patients than in BPPV patients.
Conclusion: The significant increase in NLR, SII, and SIRI levels in VN patients compared with BPPV patients suggests a more prominent role of inflammatory mechanisms in the pathogenesis of vestibular neuritis. These readily available and inexpensive biomarkers may serve as supportive tools in the differential diagnosis of peripheral vertigo in clinical practice.
Keywords
References
- 1. Petri M, Chirila M, Bolboaca S,et al. Unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania. Clujul Med. 2015;88(2):181-187. doi:10.15386/cjmed-412
- 2. Hung SH, Xirasagar S, Dang LH, et al. Trends in the incidence of peripheral vestibular disorders: a Nationwide population-based study. Front Neurol. 2023;14:1322199. doi:10.3389/fneur.2023.1322199
- 3. von Brevern M, Bertholon P, Brandt T, et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2015;25(3-4):105-117. doi:10.3233/VES-150553
- 4. Bae CH, Na HG, Choi YS. Current diagnosis and treatment of vestibular neuritis: a narrative review. J Yeungnam Med Sci. 2022;39(2):81-88. doi:10.12701/yujm.2021.01228
- 5. Bucak A, Ulu S, Oruc S, et al. Neutrophil-to-lymphocyte ratio as a novel-potential marker for predicting prognosis of Bell palsy. Laryngoscope. 2014;124(7):1678-1681. doi:10.1002/lary.24551
- 6. Ferroni P, Riondino S, Formica V, et al. Venous thromboembolism risk prediction in ambulatory cancer patients: clinical significance of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio. Int J Cancer. 2015;136(5):1234-1240. doi:10.1002/ijc.29076
- 7. Özler GS. Increased neutrophil-lymphocyte ratio in patients with idiopathic sudden sensorineural hearing loss. J Craniofac Surg. 2014;25(3):e260-263. doi:10.1097/SCS.0000000000000565
- 8. Chung JH, Lim J, Jeong JH, Kim KR, Park CW, Lee SH. The significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in vestibular neuritis. Laryngoscope. 2015;125(7):E257-261. doi:10.1002/lary.25204
Details
Primary Language
English
Subjects
Neurology and Neuromuscular Diseases
Journal Section
Research Article
Authors
Yusuf Aydin
0000-0002-0964-0405
Türkiye
Publication Date
March 12, 2026
Submission Date
September 22, 2025
Acceptance Date
October 23, 2025
Published in Issue
Year 2026 Volume: 6 Number: 1