What Is Vestibular Neuritis?

Vestibular neuritis is a neural disorder of the inner ear. This condition is triggered by an inflammation of the vestibular nerve, which works with your brain to help you maintain your balance. Persons with vestibular neuritis have trouble standing and experience a number of symptoms, including dizziness, vertigo, and nausea. It often occurs in two phases: an early severe phase and a later, chronic phase with similar but milder symptoms.

If you or a loved one are suffering from balance or motion issues, seek medical care. The Baptist Health ear, nose, and throat (ENT) team is available to assist you.

What Is the Difference Between Vestibular Neuritis and Labyrinthitis?

Vestibular neuritis is essentially one-half of a related disorder called labyrinthitis. The latter results from inflammation of or damage to the vestibular nerve and the cochlear (auditory) nerve. Individuals with labyrinthitis suffer from both balance and hearing issues. Vestibular neuritis leaves hearing largely unaffected.

Symptoms

Someone with vestibular neuritis usually experiences it in two phases. The first phase occurs suddenly and can be severe; the second more gradually with reduced characteristics.

Symptoms of the acute phase include:

• Difficulty standing or maintaining one’s balance
• Dizziness
• Loss of concentration
• Loss of eye-muscle control (called nystagmus)
• Motion sensitivity
• Nausea
• Vertigo (a feeling of spinning or whirling around)
• Vomiting

The symptoms of the second, chronic phase are milder versions of those in the first. You may also experience anxiety or a feeling of blockage in the ears.

What Causes Vestibular Neuritis?

Medical researchers agree that the primary cause of vestibular neuritis is viral infection. Certain viruses attack the vestibular nerve, inflaming it and the surrounding tissues, which hampers the nerve’s ability to communicate with the brain. Included among this group of viral infections are:

• Chicken pox
• COVID-19
• Hepatitis
• Herpes simplex virus 1
• Influenza
• Measles
• Mononucleosis
• Mumps
• Polio
• Rubella (“German measles”)
• Shingles

Individuals in middle age (30 to 60 years old) are more likely to develop vestibular neuritis than older or younger persons. It appears to affect men and women about equally.

Diagnosing Vestibular Neuritis

The diagnosis of vestibular neuritis is most often undertaken by an otolaryngologist or ear, nose, and throat specialist. Because there is no single test for identifying this disorder, the diagnostic process includes several possible steps:

• Symptom and medical history: Your physician will ask you questions about your symptoms and document your answers. He or she will also be interested in your family medical history.
• Balance and gait testing: Because vestibular neuritis impairs the proper functioning of the inner ear, you may undergo tests that measure your ability to stand up, move from place to place, and perform various physical tasks.
• Neurological testing and MRI scan: Imbalance can have causes other than viral infection. Your physician may conduct a number of neurological tests, including a magnetic resonance imaging (MRI) scan, to identify or eliminate other possible causes of balance issues, such as a stroke or tumor.
• Hearing tests: Hearing tests can be used to determine whether hearing loss is associated with the balance issues that you’re having. Included among these tests are those which focus specifically on the inner ear, including otoacoustic emission tests, bone-conduction exams, and auditory brainstem response tests.
• Vestibular testing: Vestibular testing is an equivalent set of tools for measuring the effectiveness of the inner ear in regulating balance. There are several of these tests, some focused on the neural health of the brain, some on parts of the inner ear, such as the otoliths or semicircular canals, and some on how well the sensory organs and inner ear are working together.

Hearing and vestibular tests are typically conducted by audiologists. In some cases, a physician specializing in neurology may also have a role in the diagnosis.

Treatment

If you have vestibular neuritis, your condition should improve on its own over time. The goal of treatment in cases like this becomes symptoms management, freeing the patient to return to the normal activities of living.

There are two primary means of treating vestibular neuritis. The first is medications, which include:

• Anti-nausea drugs
• Drugs for controlling dizziness
• Antiviral medications
• Anti-inflammatories for improving the health of the vestibular nerve

For more serious cases of vestibular neuritis, there is also physical therapy. Vestibular physiotherapy includes exercises that focus on:

• Balance
• Gaze stabilization
• Positional awareness
• Reduced movement sensitivity
• Visual tracking

Recovery times for persons with vestibular neuritis vary. Many recover quickly after the initial acute phase. Others take longer, with lingering symptoms. The amount of time often depends on the degree of damage inflicted on the vestibular nerve by a viral infection.

Can Vestibular Neuritis be Prevented?

The only way of preventing vestibular neuritis is to avoid the viral infections that cause it. The best means of doing so is keeping current on all your vaccines.

When to See a Doctor for Vestibular Neuritis

Vestibular neuritis is a serious medical condition resulting from a viral infection that attacks the inner ear. It can lead to a loss of balance and movement, dizziness, vertigo, and nausea. Although it will gradually heal on its own, symptoms can be managed with proper diagnosis and treatment. If you think that you may be suffering from vestibular neuritis or a related ear disorder, schedule an appointment with an audiologist today!