Vertigo - Vestibular Neuronitis

Question 1

What is Acute Vestibular Neuronitis?

Answer 1

Inflammation of the vestibular nerve - usually viral infection.

Question 2

Anatomy of the Inner Ear.

Answer 2

Bony Labyrinth - Perilymph and Endolymph inside Inner Ear (Semicircular Canals, Vestibule, Cochlea).

Question 3

Anatomy of the Vestibular System (2).

Answer 3

1. Semicircular Canals inside Utricle + Saccule of Vestibule : Rotation of Head.
2. Otolith Organs inside Utricle + Saccule of Vestibule : Gravity and Linear Acceleration.

Question 4

Clinical Features of Acute Vestibular Neuronitis (4).

Answer 4

1. Acute Onset of Vertigo (Severe First Few Days).
2. Recent Viral URTI.
3. N&V.
4. Balance Problems.
5. NO Hearing Loss.

Question 5

Management of Acute Vestibular Neuronitis (3).

Answer 5

1. Admission if Dehydrated due to N&V.
2. Prochlorperazine and Antihistamines for up to 3 days maximum.
3. Vestibular Rehabilitation Therapy Referral if no improvement after 1 week or taking more than 6 weeks to resolve.

Question 6

Prognosis of Acute Vestibular Neuronitis (3).

Answer 6

1. Most severe for first few days.
2. Gradual resolution over 2-6 weeks.
3. BPPV may develop after.