Labrynthitis/ Vestibular Neuronitis Flashcards
What is the cause?
Inflammation of the inner ear
What symptoms are associated?
Severe vertigo (incapacitating) - no positional
Loss of balance
Nausea and vomiting
How long does the vertigo last?
Lasting several days, before starting to improve
What signs are associated?
Horizontal nystagmus
What does this condition often follow?
A recent URTI
How is it managed?
Vestibular rehabilitation exercises - Cawthorne- Cooksey exercises twice daily
Acute episode: prochlorperazine to provide rapid relief and IV fluids if required
Encourage mobility
After the acute episode what can occur?
Long term vestibular deficit, which can lead to generalised unsteadiness for a number of weeks
What examination can be used to distinguish from a posterior circulation stroke?
The HiiNTS exam
Why should prochlorperazine be stopped after the acute phase?
It delays recovery by interfering with central compensatory mechanisms
If the patient is vomiting, can prochlorperazine be given IM?
Yes and subsequently switch to oral
Should betahistine be given?
It is often used, but little evidence that it is effective in vestibular neuronitis
Is hearing typically affected?
No
Can the inner ear become swollen and painful?
Yes
Is there tinnitus?
Usually not
When do symptoms commonly occur?
On awakening
