- Clinical science
Vestibular neuritis is a type of acute unilateral vestibulopathy of unknown origin, although it tends to occur after viral infection of the upper airways. The disorder presents with acute-onset vertigo, nausea, vomiting, and gait instability in otherwise healthy patients. Symptomatic treatment includes bed rest and medication, while rehabilitation involving vestibular exercises speeds up recovery. With proper treatment, symptoms typically disappear within 2–3 weeks.
- Vestibular neuritis is an idiopathic disease.
- It tends to occur more often after upper airway infections
Acute onset in otherwise healthy patients. Severe symptoms last for 1–2 days, mild symptoms may persist for weeks or even months:
- Severe vertigo
- Nausea and vomiting
- Gait instability
- Increased risk of falling towards the affected side
- Patient history may include recent infection of the upper airways.
There is no confirmatory test. The diagnosis is therefore primarily based on clinical findings and the patient history.
- Head thrust test: The examiner turns the patient's head rapidly towards the affected side → positive if the patient is unable to maintain visual fixation
Imaging studies (only used to rule out a or a brain tumor; not for routine diagnostics!)
- Audiogram: unremarkable
Imaging studies are indicated in patients older than 60 years, as well as those with persistent vestibular symptoms, headache, vascular risk factors, or focal neurologic symptoms!
|Vertigo|| || || || |
|Others|| || || |
- Bed rest
- Corticosteroids (e.g., prednisolone)
- Symptomatic treatment
Vestibular rehabilitation therapy
Vestibular rehabilitation is generally used to treat patients with permanent vestibular injury, but it may also speed up recovery in patients suffering from vestibular neuritis. It consists of three different types of exercises:
- Exposure to stimuli
- Gaze stabilizing head exercises:
- Balance exercises:
- Vestibular rehabilitation is generally used to treat patients with permanent vestibular injury, but it may also speed up recovery in patients suffering from vestibular neuritis. It consists of three different types of exercises: