Vestibular neuronitis is a disorder characterized by a sudden severe attack of vertigo (a false sensation of moving or spinning), caused by inflammation of the nerve to the semicircular canals (part of the vestibular system, which helps control balance).
Vestibular neuronitis is probably caused by a virus. It may occur as a single, isolated attack of vertigo lasting several days, although many people have additional attacks of milder vertigo for several weeks thereafter. The first attack of vertigo is usually the most severe. The attack, which is accompanied by nausea and vomiting, lasts for 7 to 10 days. The eyes rapidly jerk in one direction alternating with a slower drift back to the original position (a sign called nystagmus). Each subsequent attack is shorter and less severe than the previous one and typically occurs only when the head is in certain positions. Hearing is usually not affected.
The diagnosis involves hearing tests and tests for nystagmus (see Symptoms of Ear Disorders: What the doctor does). Magnetic resonance imaging (MRI) of the head may be performed to make sure the symptoms are not caused by another disorder, such as a tumor.
Treatment of vertigo is done only to relieve the symptoms it causes and consists of drugs such as meclizine, lorazepam, or scopolamine. These drugs should only be used temporarily, because prolonged use may actually lengthen the duration of symptoms, preventing the brain from compensating for the vestibular loss. Nausea and vomiting may be relieved by pills or suppositories containing the drug prochlorperazine. If vomiting continues for a long time, a person may need to be given fluids and electrolytes by vein (intravenously). Although the vertigo subsides relatively quickly (over the course of several days), the feeling of dizziness may last for up to several weeks. During this time, doctors encourage people to stay active.
Last full review/revision October 2012 by Lawrence R. Lustig, MD