Summary about Disease
Vestibular neuritis is an inflammation of the vestibular nerve, which is located in the inner ear and transmits information about balance to the brain. This inflammation disrupts the nerve's ability to properly send signals, leading to sudden onset of vertigo (a sensation of spinning), nausea, and imbalance. Unlike labyrinthitis, which also involves the inner ear, vestibular neuritis typically does not affect hearing.
Symptoms
Sudden onset of severe vertigo (spinning sensation)
Nausea and vomiting
Imbalance and difficulty walking
Dizziness
Blurred vision
Concentration difficulties
Feeling of being pulled to one side
Causes
The exact cause of vestibular neuritis is not fully understood, but it is widely believed to be caused by a viral infection. This infection can affect the vestibular nerve directly, causing inflammation and disrupting its function. Viruses implicated include herpes simplex virus (HSV), which causes cold sores.
Medicine Used
Corticosteroids: Such as prednisone, may be prescribed early in the course of the illness to reduce nerve inflammation. Their effectiveness is debated, but some studies suggest they can improve long-term vestibular function if started promptly.
Antiemetics: Medications to relieve nausea and vomiting, such as prochlorperazine or ondansetron.
Antihistamines/Anticholinergics: Medications like meclizine or dimenhydrinate to suppress vertigo and motion sickness.
Benzodiazepines: Such as diazepam or lorazepam, can help reduce anxiety and suppress vertigo, but are typically used short-term due to their potential for side effects and dependence.
Vestibular Rehabilitation Therapy (VRT): A form of physical therapy designed to help the brain compensate for the damaged vestibular nerve.
Is Communicable
Vestibular neuritis itself is not communicable. However, if the underlying cause is a viral infection, the virus *could* be communicable through typical routes (e.g., respiratory droplets for some viruses). But, the vestibular neuritis is a result of the infection, and not directly transmitted person-to-person.
Precautions
Prevent falls: Due to imbalance and dizziness, take precautions to avoid falls. This may include using assistive devices like canes or walkers, ensuring good lighting, and removing tripping hazards in your home.
Avoid driving or operating heavy machinery: Until symptoms improve significantly.
Stay hydrated: Especially if experiencing nausea and vomiting.
Rest: Allow your body to recover.
Consult a doctor: For diagnosis and treatment.
Follow VRT exercises: If prescribed by a physical therapist.
How long does an outbreak last?
The acute phase of vestibular neuritis, characterized by severe vertigo, typically lasts for a few days to a week. Symptoms then gradually improve over several weeks to months as the brain compensates for the damaged nerve. Some individuals may experience residual dizziness or imbalance for longer periods. The majority recover within a few months.
How is it diagnosed?
Diagnosis typically involves:
Medical history and physical examination: A doctor will ask about your symptoms and perform a neurological exam, including tests to assess balance and eye movements.
Vestibular testing: Tests such as electronystagmography (ENG), videonystagmography (VNG), caloric testing, and video head impulse testing (vHIT) can help evaluate the function of the vestibular nerve.
Hearing test (audiometry): To rule out other conditions like Labyrinthitis.
MRI: In some cases, an MRI of the brain may be performed to rule out other causes of vertigo, such as a stroke or tumor.
Timeline of Symptoms
Day 1-7: Sudden onset of severe vertigo, nausea, vomiting, and imbalance. This is the acute phase.
Week 2-4: Symptoms gradually begin to improve as the brain starts to compensate. Dizziness and imbalance may persist.
Month 1-3: Continued improvement in balance and reduction in dizziness. Some individuals may experience occasional relapses or residual symptoms, especially with head movements.
After 3 months: Most individuals experience significant recovery. Some may have mild, persistent dizziness or imbalance.
Important Considerations
Differential Diagnosis: It's crucial to differentiate vestibular neuritis from other causes of vertigo, such as stroke, Meniere's disease, benign paroxysmal positional vertigo (BPPV), and migraine-associated vertigo.
Early Treatment: While the condition often resolves on its own, early treatment with corticosteroids (if appropriate) and vestibular rehabilitation therapy may improve outcomes.
Psychological Impact: The sudden onset of severe vertigo can be very distressing and may lead to anxiety and depression. Support and counseling may be helpful.
Fall Risk: Be mindful of the increased risk of falls, especially during the acute phase.
Individual Variability: Recovery time and symptom severity can vary significantly from person to person.