목적: The efficacy of steroid in vestibular neuritis (VN) is controversial. The aim of this study was to examine the additional effectiveness of methylprednisolone for vestibular neuritis by using video head impulse test (vHIT). 방법:This study was a prospective, randomized controlled study. The 32 VN patients were randomized to either group (15 ginkgo and 17 steroid groups). Ginkgo group received ginkgo biloba (160 mg/d) and steroid group received both ginkgo biloba and methylprednisolone (48 mg/d for 9 days and tapering) for 2 weeks. After the initial vestibular function tests (VFT) including caloric, vestibular evoked myogenic potential (VEMP), video head impulse test (vHIT), sensory organization test (SOT), dizziness handicap index (DHI) at acute stage, VFTs were repeated 1, 6 months later. The parameters of VFTs and DHI scores were compared in both groups. 결과:At 1 month after treatment, canal paresis (CP) in ginkgo group decreased from 64.924.6% to 41.2536.1% (p=0.015), and that of steroid group decreased from 66.9523.55% to 51.031.4% (p=0.023). However, the degree of CP improvement between them was not different. Ginkgo group showed significant improvement of vHIT LSCC gains at 1 month (from 0.600.33 to 0.840.30, p=0.013), and steroid group also showed significant improvement from 0.540.30 to 0.700.33 (p=0.015). But, the difference of improvement between 2 groups was not different. The incidence of normalized vHIT gains at 1 month was 53% (8 of 15) in ginkgo group, and 35% (6 of 17) in steroid group, which was also not significant (p=0.476). And there was no significant differences in improvement and normalized ratio in ocular and cervical VEMP, SOT, and DHI score between 2 groups. 결론:When 1 month post-treatment VFT result was compared with pretreatment VFT, methylprednisolone didn't have any additional benefit in the improvement of symptoms and objective parameters. However, longer follow-up period is needed to see the long-term effect of steroid.