Vestibular Neuritis

Vertigo is a term used by doctors to describe the virtual feeling that you are spinning, or that the world around you is spinning, and may be accompanied by nausea and disequilibrium.

Vestibular neuronitis is a clinical diagnosis made in patients suffering from a rapid onset of vertigo, nausea and vomiting without significant hearing loss. What are some other names that doctors may use instead of vestibular neuronitis? It may also be referred to as acute labyrinthitis, epidemic vertigo, vestibular paralysis, or Meniere’s disease.

What happens when someone has vestibular neuronitis?

It most often begins with a rapid onset of vertigo accompanied by nausea and vomiting. Sometimes the beginning of the vertigo is not as rapid, and some people may only complain of some dizziness (lightheadedness, wooziness, disorientation) and nausea. Many times people can be awakened at night with these feelings or it is first noticed when getting out of bed. Most people feel better when lying flat and still. Head movements can worsen the vertigo and nausea.

How long can it last?

The initial attack can last from a few hours to a whole day. After the initial episode resolves, people can experience dizziness or imbalance while walking or with rapid head turns that can sometimes last up to three months. Thirty percent of patients experience positional vertigo when rolling over in bed. In most cases, patients recover from the initial attack and positional vertigo. Over time, with vestibular rehabilitation exercises, they recover their balance quicker.

What causes vestibular neuronitis?

Pathological studies of the ear indicate that a virus has infected the balance nerve in the ear.

How do ear, nose, and Throat (ENT) doctors diagnose vestibular neuronitis?

The history of the patient is most important. Complete evaluation of hearing and balance with testing usually shows a loss of function of the balance center on one side and normal hearing. Tests also confirm that a benign tumor is not present and that hearing is normal.

How do we treat vestibular neuronitis?

When patients have their initial attack of vertigo, medications can be given to help with nausea and/or vomiting. They are also encouraged to increase their fluid intake. After the initial attack subsides, “vestibular rehabilitation,” otherwise known as balance retraining therapy, is recommended. Medication in the recovery phase reduces the effectiveness of the balance exercises. Most patients recover completely after treatment in three to six months.