Vestibular neruonitis

Question 1

What is vestibular neuronitis

Answer 1

Inflammation of the vestibular nerve

Question 2

Pathophysiology of vestibular neuronitis

Answer 2

Viral infection may trigger the inflammation, which distorts the signals travelling from the vestibular system to the brain, cofusing signal required to sense movements of head.

Question 3

Presentation fo vestibular neuronitis

Answer 3

Acute onset vertigo, history of recent viral upper RTI. Symptoms most severe in first few days, associated with nausea, vomiting and balance problems.

Question 4

Diagnosis of vestibular neuronitis

Answer 4

Clinical signs and symptoms, head impulse test to confirm peripheral cause

Question 5

Differential of vestibular neuronitis

Answer 5

If there is hearing loss, consider labyrinthitis

Question 6

Management of vestibular neuronitis

Answer 6

Admission if severe vomiting causing dehydration. Short term management includes prochlorperazine and antihistamines.

Question 7

What happens if symptoms do not get better after 1 weeks or resolve after 6 weeks

Answer 7

Further investigations or vestibular rehabilitation therapy

Question 8

Prognosis

Answer 8

Gradually resolve over the following 2-6 weeks, BPPV may develop after