What Is Vestibular Neuritis?

Inflammation of a nerve in the inner ear can cause sudden, severe vertigo.

Vestibular neuritis is an inflammation of the vestibular portion of the vestibulocochlear nerve, which relays messages from the vestibular organs of the inner ear to the brain.

The vestibular organs include three, loop-shaped semicircular canals and two sac-shaped structures, the utricle and the saccule.

Fluid and hair cells in these organs provide the brain with information about the position and movement of the head. The brain uses this information to help maintain balance.

The brain integrates the messages it receives from the left and the right ears. If the messages it’s receiving from the two ears are different, because one ear is affected by vestibular neuritis, dizziness or vertigo results.

Symptoms of vestibular neuritis typically start with a sudden attack of vertigo (a sensation of swaying or spinning) or dizziness, often accompanied by difficulty with vision or balance.

Vestibular neuritis — also called vestibular neuronitis — can occur in people of any age but is rarely reported in children.

Symptoms

Symptoms of vestibular neuritis can range from mild dizziness to a violent spinning or swaying sensation (vertigo). Symptoms can also include nausea, vomiting, difficulty with vision, and impaired concentration.

Sometimes symptoms are so severe that a person has trouble standing up or walking.

Usually, symptoms of vestibular neuritis come on suddenly. They may be present upon awakening or develop during the course of daily activities. People often seek medical help immediately because of the severity of early symptoms.

The most severe symptoms of vestibular neuritis generally last for a matter of days. Less-severe symptoms gradually diminish over several weeks, and some people recover completely.

However, if the vestibular nerve has been damaged — by a viral infection, for example — a person may develop chronic dizziness.

Diagnosis

A diagnosis of vestibular neuritis is reached partially through the process of elimination, ruling out other possible causes of dizziness such as stroke, allergies, drug side effects, or other neurological disorders or medical conditions.

One clue that a person has vestibular neuritis is horizontal nystagmus, or rapid eye movements, in the direction of the unaffected ear, especially if there are no other neurologic symptoms (e.g., vision changes, weakness, or impaired sensation).

A vestibular specialist may also conduct hearing tests, balance tests, and a test that measures a person’s ability to focus on objects during rapid head movements (called a head thrust test).

Causes

Most cases of vestibular neuritis are thought to be caused by a viral infection. The infection may be associated with a systemic viral infection (affecting the whole body), or it may be confined to the inner ear.

Some of the systemic viral infections that have been associated with vestibular neuritis include herpes virus, measles, mononucleosis, influenza, mumps, and hepatitis.

Rarely, vestibular neuritis may be a complication of a bacterial middle ear infection that has traveled to the inner ear.

Treatment

Acute vestibular neuritis is treated with medicines to suppress nausea and dizziness. Steroids, antiviral drugs, and antibiotics (if a bacterial infection is present) may also be prescribed, and intravenous fluids may be administered if a person has become dehydrated from vomiting.

With prompt treatment, vestibular neuritis usually causes no permanent damage.

If symptoms of dizziness or imbalance persist for many months after treatment for acute vestibular neuritis, a physician may suggest vestibular rehabilitation exercises. These exercises can help the brain adapt to and compensate for any residual vestibular dysfunction.

To develop an individualized set of exercises, a vestibular physical therapist first evaluates the functioning of the various parts of the body involved in balance, including the legs and feet, the eyes, and the inner ears.

Depending on the particular deficits the therapist finds, a variety of exercises are prescribed. They may include such activities as:

• Shifting the body weight from side to side or from front to back while standing
• Focusing the eyes on an object while turning the head from side to side
• Focusing the eyes on a more distant target while walking toward it, taking occasional brief glances at the floor

Once learned, vestibular physical therapy exercises can generally be done at home and need to be done two or three times a day for best results.

Sources:

• Vestibular Disorders Association.
• Vestibular Neuritis; Cleveland Clinic.
• Ears; The Merck Manual Home Edition.

Source: http://www.everydayhealth.com