Abstract
BACKGROUND: Vestibular neuritis (VN) is an acute vestibular syndrome often attributed to viral or post-viral inflammation, though evidence for seasonal or environmental triggers remains inconsistent. While early studies suggested spring or summer peaks, more recent data have questioned whether VN incidence follows a clear seasonal pattern. Beyond broad seasonality, specific meteorological factors may influence VN occurrence. OBJECTIVE: This study aims to investigate seasonal variation and associations between VN incidence and local weather anomalies in a Mediterranean climate. METHODS: We retrospectively reviewed VN cases presenting to a tertiary hospital in Patras, Greece, between January 2020 and September 2025. Diagnoses were based on Bárány Society criteria. Daily meteorological data (temperature, wind speed, atmospheric pressure) were obtained from Meteostat and aggregated by month. We assessed seasonality with a chi-square goodness-of-fit test and calculated Pearson correlations between monthly VN cases and weather anomalies (deviations from long-term monthly means). Bonferroni correction was applied for multiple testing. RESULTS: A total of 102 VN patients were identified (mean age, 54.7 ± 15.4 years; 58 (56.9%) female cases). No significant seasonality was observed in monthly case distribution (χ² = 14.58, p = 0.2). However, maximum temperature anomalies were positively correlated with VN cases (r = 0.39, p = 0.0009; Bonferroni-adjusted p = 0.0047). Wind speed and average temperature anomalies demonstrated a negative and positive correlation with VN cases, respectively (p < 0.05), which did not reach significance after Bonferroni correction (p > 0.01). Other meteorological variables showed no significant associations. CONCLUSION: The incidence of VN in our cohort did not follow a strict seasonal pattern but was significantly associated with higher-than-average monthly maximum temperatures. This supports a multifactorial pathogenesis in which viral reactivation, vascular compromise, and immune dysregulation may interact with environmental stressors. These findings highlight the importance of considering climatic influences in VN and warrant further multicenter, high-resolution studies integrating virological and environmental data.