Vestibular Neuritis

The vestibular system, found in the inner ear, is a sensory organ responsible for perceiving movement and maintaining balance in most mammals. Vestibular neuritis occurs when the vestibular system is damaged, resulting in clinical symptoms. However, what are the underlying causes of this condition?

The symptoms associated to this condition include:

• Sudden and severe dizziness, often accompanied by a spinning or rocking sensation.
• Dizziness, generally persisting throughout the episode.
• Difficulty with balance, making it challenging to maintain stability.
• Nausea, a common symptom experienced during episodes.
• Difficulty concentrating, which can be attributed to the disruptive effects on balance.

Vestibular neuritis and labyrinthitis are closely related diseases. Vestibular neuritis involves the inflammation of a branch of the vestibulocochlear nerve responsible for balance. Labyrinthitis, on the other hand, involves inflammation of both branches of the vestibulocochlear nerve, affecting both balance and hearing. The symptoms of labyrinthitis are similar to those of vestibular neuritis, with the addition of tinnitus (ringing in the ears) and/or hearing loss.

Vestibular neuritis is diagnosed by a specialist, like an otologist or neurotologist, during an office visit. An audiologist may also be involved in conducting tests to assess hearing and vestibular damage.

To help confirm the diagnosis, specialists will run tests, including hearing tests, balance tests and assessments for vestibulocochlear nerve damage. The presence of nystagmus, characterized by rapid and uncontrollable eye movement, serves as an indication of vestibular neuritis. 

If symptoms persist or worsen, further tests may be conducted to explore other potential causes like stroke, head injury, brain tumour, or migraine. An MRI with contrast may be ordered to rule out certain brain disorders.

If symptoms persist for more than a few weeks, it is best to undergo a vestibular rehabilitation program. The primary objective of this program is to retrain the brain to adapt to the changes in balance experienced by the patient. The program start with a thorough evaluation conducted by a vestibular physical therapist, focusing on various areas that influence balance, including:

• Legs: Assessing the leg's ability to perceive balance sensations while standing or walking.
• Eyes: Evaluating how effectively the sense of sight interprets the body's position in relation to its surroundings.
• Ears: Gauging the inner ear's functionality in maintaining balance.
• Body as a whole: Analysing how well the body comprehends its centre of gravity, such as detecting swaying or unstable posture.

Based on the assessment outcomes, a customized exercise regimen is devised specifically for the patient.