The vestibule is a part of the inner ear that contains organs controlling balance (see also Overview of the Inner Ear Overview of the Inner Ear The fluid-filled inner ear (labyrinth) is a complex structure consisting of two major parts: The organ of hearing (cochlea) The organ of balance (vestibular system) The cochlea and the vestibular... read more ). It is connected to the brain by the vestibular nerve. Vestibular neuronitis is probably caused by a virus.
Symptoms of Vestibular Neuronitis
Vestibular neuronitis may occur as a single, isolated attack of severe vertigo Dizziness and Vertigo Dizziness is an inexact term people often use to describe various related sensations, including Faintness (feeling about to pass out) Light-headedness Dysequilibrium (feeling off balance or... read more lasting 7 to 10 days, but many people have additional attacks of milder vertigo for several weeks thereafter. The first attack of vertigo is usually the most severe. Vertigo is a false sensation that people, their surroundings, or both are moving or spinning. Most people describe this unpleasant feeling as "dizziness," although people often also use the word "dizzy" for other sensations, such as being light-headed.
The attack of vertigo is accompanied by nausea, vomiting, and nystagmus (a rapid jerking movement of the eyes in one direction alternating with a slower drift back to the original position). The vertigo is severe at first, and gradually subsides over the course of several days, with residual imbalance lasting up to several months. People do not have tinnitus (ringing in the ears), and hearing is usually not affected.
Diagnosis of Vestibular Neuronitis
Tests for nystagmus
Gadolinium-enhanced magnetic resonance imaging (MRI)
The diagnosis of vestibular neuronitis involves hearing tests and tests for nystagmus What the doctor does Dizziness is an inexact term people often use to describe various related sensations, including Faintness (feeling about to pass out) Light-headedness Dysequilibrium (feeling off balance or... read more , which help doctors diagnose the cause of vertigo.
Gadolinium-enhanced MRI Magnetic Resonance Imaging (MRI) In magnetic resonance imaging (MRI), a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe... read more of the head should be done to make sure the symptoms are not caused by another disorder, such as a tumor.
Treatment of Vestibular Neuronitis
Drugs such as meclizine or lorazepam to relieve vertigo
Drugs such as prochlorperazine to relieve vomiting
Sometimes corticosteroid drugs such as prednisone
Intravenous fluids if vomiting persists
In people with vestibular neuronitis, treatment of vertigo is done only to relieve the symptoms it causes and consists of drugs such as meclizine or lorazepam. Nausea and vomiting may be relieved by pills or suppositories containing the drug prochlorperazine. These drugs should only be used for a short amount of time, because prolonged use may actually lengthen the duration of symptoms, particularly in older people. Additionally, corticosteroids are used briefly. 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), a feeling of dizziness may last for up to several weeks to months. During this time, doctors encourage people to stay active. A specialized form of physical therapy, called vestibular therapy, may be helpful.
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