The vestibular nerve is responsible for transmitting information about balance and spatial orientation to the brain. In Vestibular neuritis, inflammation of this nerve causes dizziness which is usually accompanied with nausea and vomiting.
Symptoms: The spinning sensation of vestibular neuritis typically begins suddenly and can last for hours to days. After a few days, the acute spinning slowly subsides and unsteadiness becomes the prominent symptom.
Cause: The exact cause of vestibular neuritis is not known, but it is thought to be related to a viral infection. In some cases, vestibular neuritis may be triggered after a respiratory infections or flu. Reduced immunity can increase the risk of vestibular neuritis.
Diagnosis: Vestibular tests need to be done to evaluate the cause of vertigo and dizziness. These tests include -Videonystagmography (VNG), Video Head Impulse Test (VHIT) and Dynamic Visual Acuity (DVA). Audiometry should be done to rule out any hearing loss.
Differential Diagnosis: Vestibular neuritis should be differentiated from other possible causes of acute vertigo like posterior circulation stroke, labyrinthitis, Meniere’s disease and autoimmune inner ear disease. The typical history and investigations help to reach the correct diagnosis
Treatment: Vestibular neuritis should be recognised and treated as soon as possible to ensure a good recovery. The goal of treatment in the initial phase is to reduce the symptoms and improve the balance control. Medications have a role in the treatment vestibular neuritis only in the 1st 5 days. High dose steroids may be given to reduce the inflammation of the vestibular nerve. In the initial few days, medicines to suppress the vertigo and vomiting may be given eg. Procloperazine, cinnarizine or meclizine. But these medicines should be stopped as soon as possible as they slow down the recovery process.
Customized vestibular rehabilitation therapy should be initiated as soon as possible. This therapy is aimed at improving balance and reduce dizziness with targeted progressive exercises. The earlier vestibular rehabilitation is started, the better is the overall recovery. Untreated vestibular neuritis will lead to sub-optimal recovery and chances of chronic dizziness.
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