Vestibular Neuronitis
Definition
Acute onset of disabling vertigo often accompanied by nausea, vomiting and imbalance that resolves over days leaving a residual imbalance that lasts days to weeks
Aetiology
Acute phase:
Incomplete recovery likely with the following risk factors: elderly, visual impairment, poor
Ambulation
Repeated attacks can occur
Treatment
Acute phase:
Source
Toronto Notes 2012
Acute onset of disabling vertigo often accompanied by nausea, vomiting and imbalance that resolves over days leaving a residual imbalance that lasts days to weeks
Aetiology
- Thought to be due to a viral infection (e.g. measles, mumps, herpes zoster)
- ~30% of cases have associated URTI symptoms
- Other: microvascular events, diabetes, autoimmune process
- Considered to be the vestibular equivalent of Bell's palsy, sudden hearing loss, and acute vocal cord palsy
Acute phase:
- Severe vertigo with nausea, vomiting, and imbalance lasting 1 to 5 d
- Irritative nystagmus (fast phase towards the offending ear)
- Patient tends to veer towards affected side
- Imbalance and motion sickness lasting days to weeks
- Spontaneous nystagmus away from affected side
- Gradual vestibular adaptation requires weeks to months
Incomplete recovery likely with the following risk factors: elderly, visual impairment, poor
Ambulation
Repeated attacks can occur
Treatment
Acute phase:
- Bed rest, vestibular sedatives (Gravole), diazepam
- Progressive ambulation especially in the elderly
- Vestibular exercises: involve eye and head movements, sitting, standing, and walking
Source
Toronto Notes 2012