Vestibular neuronitis

Vestibular neuronitis

Description, Causes and Risk Factors:

Abbreviation: VN.

Alternative Name: Vestibular neuritis, labyrinthitis, Gerlier disease, kubisagari, endemic paralytic vertigo, epidemic vertigo, paralyzing vertigo.

Vestibular neuronitis is the third most common cause of peripheral vertigo. The reported incidence is 3.5 per 100,000 and accounts for 7% of patients seen in vertigo specialty clinics.

Vestibular neuronitis

The inner ear includes the cochlea, vestibule and semicircular canals. These are small 'shell-like' structures in which there is a system of narrow fluid-filled channels called the labyrinth. The semicircular canals sense movement of your head and help to control balance and posture. The cochlea is concerned with hearing.

There are three semicircular canals (anterior, lateral and posterior). These are roughly at right angles to each other and sense movement in different directions - left-right, forward-back, and up-down head movements. The semicircular canals are connected to a larger fluid filled chamber called the vestibule which in turn is connected to the fluid filled canal in the cochlea.

Head movements are sensed because when you move your head, the fluid in the labyrinth within the semicircular canals moves too. The movement of the fluid moves tiny fine hairs that are on the inside lining of the labyrinth. When the hairs move, this triggers nerve messages to be sent to the brain via a nerve called the vestibular nerve. This gives the brain information about the movement and position of your head, even when your eyes are closed.

Vestibular neuronitis is a disorder of the vestibular system, the part of the inner ear that helps to control our body's balance. It is most often caused by a virus that damages the vestibular nerve, which sends messages about movement and balance between the inner ear and the brain. The source of the virus can be an infection of the respiratory system or the gastrointestinal system. Vestibular neuritis may also be caused by decreased blood flow in the inner ear, exposure to toxic agents, or allergic substances, all of which can damage the vestibular nerve.

Risk factors may include:

    Lyme disease.

  • Herpes simplex virus.

  • Varicella-zoster virus (Ramsey Hunt syndrome).

  • Epstein-Barr virus.

  • Cogan syndrome.

  • Cytomegalovirus.

  • Hepatitis.

  • Adenovirus.

  • In?uenza.

  • Enteroviruses.

  • Tuberculosis.

  • Otitis media.


    The main symptom is vertigo. Vertigo is dizziness with a spinning sensation.

  • Some mild hearing loss on the affected side if you have labyrinthitis.

  • Nystagmus. This is a 'shaking' of the eyes from side to side or in a rotary movement.

  • Other symptoms of a virus infection such as a sore throat, flu symptoms or a cold.

  • Pain in an ear. However, this is not normally a feature of a viral labyrinthitis or viralvestibular neuritis. If you have ear pain it may indicate that you have a bacterialmiddle ear infection that has spread to the inner ear.


There is no blood test or x-ray that can diagnose vestibular neuronitis. Rather, the diagnosis isbased on a patient's symptoms. Dizziness and vertigo are common to a wide range of medical conditions, so careful diagnosis is important. Labyrinthitis and vestibular neuritis are diagnosed using a number of tests including:

    Physical examination.

  • Hearing tests.

  • Special eye tests including an ENG (electronystagmogram).

  • Scans, including MRI, to rule out other possible causes such as tumours or hemorrhage.


The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs to attenuate vertigo, dizziness, and nausea/vomiting. Causal treatment with corticosteroids to improve recovery of peripheral vestibular function. Physical therapy (vestibular exercises and balance training) to improve central vestibular compensation.

If symptoms do not clear within a few weeks then you may be referred to an ear specialist who may recommend treatment called Vestibular Rehabilitation Therapy (VRT). This therapy uses physical and occupational therapy techniques to treat vertigo and balance disorders.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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