Presentation: Vertigo

Question 1

What is vestibular neuronitis?

Answer 1

Vestibular neuronitis is a cause of vertigo that often develops following a viral infection.

Question 2

What are the features of vestibular neuronitis?

Answer 2

Recurrent vertigo attacks lasting hours or days, nausea and vomiting may be present, horizontal nystagmus is usually present, and there is no hearing loss or tinnitus.

Question 3

What is a differential diagnosis for vestibular neuronitis?

Answer 3

Differential diagnoses include viral labyrinthitis and posterior circulation stroke. The HiNTs exam can be used to distinguish vestibular neuronitis from posterior circulation stroke.

Question 4

What is the management for severe cases of vestibular neuronitis?

Answer 4

Buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases.

Question 5

What is the management for less severe cases of vestibular neuronitis?

Answer 5

A short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases.

Question 6

What is the preferred treatment for chronic symptoms of vestibular neuronitis?

Answer 6

Vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms.