vestibular neuronitis

Question 1

What is vestibular neuronitis?

Answer 1

Vestibular neuronitis is a disorder characterised by acute, isolated, spontaneous, and prolonged vertigo thought to be due to inflammation of the vestibular nerve and often occurs after a viral infection.

Question 2

What are the most common viruses that cause vestibular neuronitis?

Answer 2

1. Herpesviruses eg. Herpes simplex virus and varicella zoster virus

Question 3

What are the 3 primary symptoms of vestibular neuronitis?

Answer 3

1. Vertigo
2. Imbalance
3. Nystagmus

Question 4

Name the 4 features in a vestibular neuronitis history?

Answer 4

1. Recurrent vertigo attacks lasting hours or days
2. Nausea and vomiting may be present
3. Horizontal nystagmus is usually present
4. No hearing loss or tinnitus

Question 5

Name 2 differential diagnosis for vestibular neuronitis?

Answer 5

1. Viral labyrinthitis
2. Posterior circulation stroke

Question 6

How can you distinguish between viral labyrinthitis and vestibular neuronitis?

Answer 6

Unlike viral labyrinthitis, vestibular neuronitis does not involve the cochlea, and therefore, hearing loss and tinnitus are not common symptoms.

Question 7

How can you distinguish between posterior circulation stroke and vestibular neuronitis?

Answer 7

the HiNTs exam can be used to distinguish vestibular neuronitis from posterior circulation stroke

Question 8

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

Answer 8

a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine)

Question 9

What is the management of acute more severe cases of vestibular neuronitis?

Answer 9

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

Question 10

What is the management of chronic vestibular neuronitis?

Answer 10

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