Vestibular neuritis was first reported in 1952 by Dix and Hallpike, and 30% of patients reporting a flu-like symptom before acquiring the disorder. The most common causes are viral infections, often resulting from systemic viral infections or bacterial labyrinthitis. Here we presented a rare case of acute vestibular neuritis after the adenoviral vector-based COVID-19 vaccination. A 51-year-old male pilot awoke early in the morning with severe vertigo, nausea, and vomiting after receiving the first dose of the ChAdOx1 nCoV-19 vaccine 11 days ago. Nasopharyngeal SARS-CoV-2 RT-PCR test and chest CT scan were inconclusive for COVID-19 pneumonia. Significant findings were a severe spontaneous and constant true-whirling vertigo which worsened with head movement, horizontal-torsional spontaneous nystagmus, abnormal caloric test, positive bedside head impulse tests, and inability to tolerate head-thrust test. PTA, MRI of the brain and internal auditory canal, and cerebral CT arteriography were normal. According to the clinical, imaging, and laboratory findings, he was admitted to the neurology ward and received treatment for vestibular neuritis. His vertigo increased gradually over 6–8 h, peaking on the first day, and gradually subsided over 7 days. Ten days later, the symptoms became tolerable; the patient was discharged with advice for home-based vestibular rehabilitation exercises. Despite the proper treatment and rehabilitation, signs of dynamic vestibular imbalances persisted after 1 year. Based on the Federal Aviation Administration (FAA) regulations, the Air Medical Council (AMC) suspended him from flight duties until receiving full recovery. Several cases of vestibular neuritis have been reported in the COVID-19 patients and after the COVID-19 vaccination. This is the first case report of acute vestibular neuritis after the ChAdOx1 nCoV-19 vaccination in a healthy pilot without past medical history. However, the authors believe that this is a primary clinical suspicion that must be considered and confirmed after complete investigations.

前庭神经炎于 1952 年由 Dix 和 Hallpike 首次报道，30% 的患者在患上这种疾病之前报告有类似流感的症状。最常见的原因是病毒感染，通常由全身病毒感染或细菌性迷路炎引起。在这里，我们介绍了在基于腺病毒载体的 COVID-19 疫苗接种后发生急性前庭神经炎的罕见病例。一名 51 岁的男性飞行员在 11 天前接受了第一剂 ChAdOx1 nCoV-19 疫苗后，清晨醒来时出现严重的眩晕、恶心和呕吐。鼻咽 SARS-CoV-2 RT-PCR 检测和胸部 CT 扫描对 COVID-19 肺炎尚无定论。重要的发现是严重的自发性和持续性真实旋转性眩晕，随着头部运动、水平扭转自发性眼球震颤、异常热量测试而恶化，床边头部冲击试验阳性，不能耐受头部冲击试验。PTA、脑和内耳道 MRI 以及脑 CT 动脉造影均正常。根据临床、影像学和实验室检查结果，他被收入神经内科病房并接受前庭神经炎治疗。他的眩晕在 6-8 小时内逐渐加重，在第一天达到顶峰，并在 7 天内逐渐消退。十天后，症状变得可以忍受；患者在接受家庭前庭康复锻炼的建议后出院。尽管进行了适当的治疗和康复，动态前庭失衡的迹象在 1 年后仍然存在。根据美国联邦航空管理局 (FAA) 的规定，航空医学委员会 (AMC) 暂停了他的飞行职责，直到他完全康复。在 COVID-19 患者中和接种 COVID-19 疫苗后，已报告了几例前庭神经炎病例。这是第一例没有既往病史的健康飞行员在接种 ChAdOx1 nCoV-19 疫苗后发生急性前庭神经炎的病例报告。然而，作者认为这是一个主要的临床怀疑，必须在全面调查后加以考虑和确认。