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Vestibular Neuritis Hits Home

Last Sunday, I had an up close and personal encounter with Vestibular Neuritis. It hit suddenly, somewhere between buttering the toast and sitting down to breakfast. I was completely symptom free 2 minutes earlier, buzzing around my kitchen making eggs and pouring coffee. I noticed a little lightheaded feeling and blurred vision as I carried my plate to the table, but when I put the plate down, I noticed the round table was spinning in a clockwise direction. I was in full blown vertigo within 20 to 30 seconds.

The irony here is that I am the director of the Balance Disorders Program at Wake Forest University Medical Center, and I teach young doctors how to evaluate patients complaining…

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 When the Room Is Spinning: Experience of Vestibular Neuritis by a Neurotologist

Vestibular neuritis (VN) is the most common cause of acute prolonged spontaneous vertigo, and is characterized by acute unilateral vestibular hypofunction, probably due to inflammation of the vestibular nerve. VN is diagnosed at the bedside when there is spontaneous horizontal-torsional nystagmus beating away from the side of the lesion, abnormal head impulse tests for the semicircular canals involved on the lesion side, and when other neurological symptoms and signs are absent. Here, as a neuro-otologist, I describe my experience during an attack of VN and discuss how it may help physicians to better understand why and what a patient feels during attacks of vertigo.

Articles of Interest

Labyrinthitis and Vestibular Neuritis

Vestibular neuritis and labyrinthitis are disorders resulting from an infection that inflames the inner ear or the nerves connecting the inner ear to the brain. The progression of these disorders are split into two phases...

Treatment of vestibular neuritis

Thus, any patient thought to have vestibular neuritis who has significant vascular risk factors should be evaluated for possible stroke. Most patients recover well from vestibular neuritis, even without treatment. Nonetheless, studies suggest that a course of oral steroids accelerates the recovery of vestibular function; whether steroids influence long-term outcome is less certain. Thus, until more data become available, it is reasonable to treat otherwise healthy individuals who present within 3 days of onset and to withhold steroids from those who are at higher risk of complications.

What is vestibular neuritis?

It is frequently caused by a virus, an infection that may occur in the respiratory system or in the gastrointestinal system, causing an inflammation of the vestibular nerve. Thus, the transmission of information collected by the nerve is disturbed and is not consistent with the rest of body receptors, such as vision, which leads to an altered sense of balance.

Resources

lesvertiges.com

Vestibular neuritis results in the sudden onset of rotational vertigo with nausea and vomiting. It is essential to note that when the patient is questioned, no auditory problems are detected (deafness, tinnitus).

VEDA

... we are the Vestibular Disorder Association or VeDA. For over 30 years, we’ve been a lifeline of support to anyone affected by vestibular (inner-ear and brain balance) disorders. We understand what you’re going through and will do whatever we can to help you on your road to recovery.

Patient

Vestibular neuritis and labyrinthitis are most commonly caused by infection with a germ (a viral infection) that affects the inner ear. These conditions typically cause vertigo, often with sickness (vomiting). Vertigo is the sensation that you or your surroundings are moving. In most cases the symptoms gradually ease and go within a few weeks as the infection clears. Medication may help to ease symptoms. There are some less common causes which may have a different outlook and treatment.