Vestibular neuronitis is a viral inner ear infection that causes sudden dizziness and vertigo, but does not affect hearing. It is diagnosed through a physical exam and can be treated with medication to manage symptoms. Most cases resolve within a few weeks, but some patients may experience recurring symptoms.
Vestibular neuronitis, or vestibular neuritis, is a disease that occurs as a result of a viral infection of the inner ear. The disorder is characterized by sudden dizziness or vertigo, but does not affect hearing. Most cases of vestibular neuronitis resolve within a few weeks.
This disorder occurs when the vestibular nerve, a nerve that specializes in sending balance signals from the ear to the brain, becomes inflamed. This often occurs after a cold and usually only affects one ear at a time. The mean age of onset is 41 years. It affects men and women equally.
People who develop vestibular neuronitis experience dizziness, often accompanied by stomach pain, vomiting, vision problems, and an inability to concentrate. Patients also experience an involuntary flickering of the eyes called nystagmus. The first attack of dizziness is usually the worst and can last for several days. Many people also experience less severe vertigo attacks for several days after the initial onset, particularly when the head is in a certain position.
Doctors diagnose vestibular neuronitis by doing a general but thorough physical exam. Most cases are fairly easy to diagnose and don’t require extensive testing. Your doctor might recommend additional tests such as magnetic resonance imaging (MRI) for patients whose symptoms last longer than a month.
Doctors often do a physical test called a Nylen-Barany or Dix-Hallpike exam to diagnose vestibular neuronitis. This test determines whether dizziness occurs due to certain head positions or movements. The doctor tilts the patient’s head to a 30 or 45 degree angle and positions the patient so that his or her head hangs over the edge of the table, then watches the patient for nystagmus. The process is then repeated with the head tilted in the other direction.
Vestibular neuronitis usually resolves on its own, so doctors usually prescribe medications that will make the patient more comfortable until symptoms stop occurring. Several medications include promethazine to control nausea, scopolamine for motion sickness, and prednisone to reduce inflammation. The drugs don’t cure the disorder, but they do make the symptoms easier to tolerate.
Most affected patients will be unable to work for several weeks. They may have trouble thinking or concentrating and often develop sensitivity to certain head movements. Most people with vestibular neuronitis will experience only one attack in their lifetime, but about 5 percent of patients develop recurring symptoms.
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