{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:23:23Z","timestamp":1770978203113,"version":"3.50.1"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T00:00:00Z","timestamp":1641427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> The aim of this study was to present some cases of acute vertigo potentially related to the coronavirus disease 2019 (COVID-19) vaccine and review the available literature about cochleovestibular dysfunction after the COVID-19 vaccination.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> In the period from May to July 2021, we evaluated 33 patients (mean age 54.3 \u00b1 14.1) with \u201cacute vertigo\u201d post COVID-19 vaccination. A detailed medical history was taken on comorbidities, types of vaccines received, and symptoms associated. All patients underwent otoneurological evaluation, such as head impulse test, nystagmus evaluation, test of skew (HINTS) examination. Head shaking test-induced nystagmus, hyperventilation-induced nystagmus, and parossistic positional nystagmus were studied to search for vestibular impairment.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Symptoms included 16 patients (48.5%) with objective vertigo, 14 patients (42.4%) with subjective vertigo, and 3 patients (9.1%) with dizziness. Of the associated ear, nose, and throat (ENT) symptoms, the most expressed was tinnitus (18.2%). Bedside examination showed absent nystagmus in 7 patients (21.2%), 9 patients (27.3%) had horizontal or rotatory nystagmus, 17 patients (51.5%) had a vertical or oblique nystagmus, negative HST, or \u201ccentral HINTS.\u201d<\/jats:p><jats:p><jats:bold>Discussion and Conclusions:<\/jats:bold> The 9 patients had an evoked nystagmus pathognomonic for benign paroxysmal positional vertigo; in the remaining 17 cases, peripheral vestibular dysfunction could be excluded and central disorder may be suggested. Due to the prevalence of nystagmus of non-peripheral origin, a central nervous system involvement could not be excluded. However, due to the small sample size, a definite cause\u2013effect relationship between vaccination and vertigo cannot be inferred. In light of expected third dose, large-scale and well-designed studies are needed to better define possible adverse reactions of the COVID-19 vaccine.<\/jats:p>","DOI":"10.3389\/fmed.2021.790931","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T04:59:36Z","timestamp":1641445176000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Acute Vertigo After COVID-19 Vaccination: Case Series and Literature Review"],"prefix":"10.3389","volume":"8","author":[{"given":"Paola","family":"Di Mauro","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignazio","family":"La Mantia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Cocuzza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pasqua Irene","family":"Sciancalepore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborak","family":"Ras\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Maniaci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore","family":"Ferlito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Tundo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Anzivino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"key":"B1","unstructured":""},{"key":"B2","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1038\/s41577-021-00578-z","article-title":"Immunological mechanisms of vaccine-induced protection against COVID-19 in humans","volume":"21","author":"Sadarangani","year":"2021","journal-title":"Nat Rev Immunol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"701501","DOI":"10.3389\/fimmu.2021.701501","article-title":"SARS-CoV-2 vaccines based on the spike glycoprotein and implications of new viral variants","volume":"12","author":"Mart\u00ednez-Flores","year":"2021","journal-title":"Front Immunol."},{"key":"B4","unstructured":""},{"key":"B5","doi-asserted-by":"publisher","first-page":"939","DOI":"10.3390\/vaccines9080939","article-title":"Nervous and muscular adverse events after COVID-19 vaccination: a systematic review and meta-analysis of clinical trials","volume":"9","author":"Chen","year":"2021","journal-title":"Vaccines (Basel)."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14992027.2021.1931969","article-title":"Tinnitus following COVID-19 vaccination: report of three cases","volume":"13","author":"Parrino","year":"2021","journal-title":"Int J Audiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1093\/qjmed\/hcab210","article-title":"The reversible tinnitus and cochleopathy followed first-dose AstraZeneca COVID-19 vaccination","volume":"114","author":"Tseng","year":"2021","journal-title":"QJM."},{"key":"B8","unstructured":""},{"key":"B9","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.emc.2020.09.011","article-title":"Diagnosis of patients with acute dizziness","volume":"39","author":"Gurley","year":"2021","journal-title":"Emerg Med Clin North Am."},{"key":"B10","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/s40463-018-0305-8","article-title":"Usage of the HINTS exam and neuroimaging in the assessment of peripheral vertigo in the emergency department","volume":"47","author":"Quimby","year":"2018","journal-title":"J Otolaryngol Head Neck Surg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"3504","DOI":"10.1161\/STROKEAHA.109.551234","article-title":"HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging","volume":"40","author":"Kattah","year":"2009","journal-title":"Stroke."},{"key":"B12","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1136\/svn-2018-000160","article-title":"Use of HINTS in the acute vestibular syndrome. 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