Vestibular neuronitis is a disorder characterized by a sudden severe attack of vertigo (a false sensation of moving or spinning) caused by inflammation of the vestibular nerve, the branch of the 8th cranial nerve that helps control balance.
The vestibule is a part of the inner ear. It contains organs that control balance (see also Overview of the Inner Ear). It is connected to the brain by the vestibular nerve. Vestibular neuronitis is probably caused by a virus.
Symptoms of Vestibular Neuronitis
Vestibular neuronitis may occur as a single, isolated attack of severe vertigo lasting 7 to 10 days, but many people have additional attacks of milder vertigo for several weeks thereafter. The first attack of vertigo is usually the most severe. Vertigo is a false sensation that people, their surroundings, or both are moving or spinning. Most people describe this unpleasant feeling as "dizziness," although people often also use the word "dizzy" for other sensations, such as being light-headed.
The attack of vertigo is accompanied by nausea, vomiting, and nystagmus (a rapid jerking movement of the eyes in one direction alternating with a slower drift back to the original position). The vertigo is severe at first, and gradually subsides over the course of several days, with residual imbalance lasting up to several months. People do not have tinnitus (ringing in the ears), and hearing is usually not affected.
Diagnosis of Vestibular Neuronitis
Hearing tests
Tests for nystagmus
Gadolinium-enhanced magnetic resonance imaging (MRI)
The diagnosis of vestibular neuronitis involves hearing tests and tests for nystagmus, which help doctors diagnose the cause of vertigo.
Gadolinium-enhanced MRI of the head should be done to make sure the symptoms are not caused by another disorder, such as a tumor.
Treatment of Vestibular Neuronitis
Intravenous fluids if vomiting persists
Physical therapy
Although the vertigo often subsides relatively quickly (over several days), a feeling of dizziness may last for up to several weeks to months. During this time, doctors encourage people to stay active. A specialized form of physical therapy, called vestibular therapy, may be helpful.
