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Vestibular neuronitis
Last reviewed: 04.07.2025
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Vestibular neuronitis is an acute (viral) lesion of the vestibular ganglion, vestibular nuclei and other retrolabyrinthine structures, identified as an independent nosological entity in 1949 by the American otolaryngologist C. Hallpike. The disease is characterized by an acute attack of vestibular dysfunction without cochlear disorders, equally common in males and females, most often at the age of 30-35 years. Vestibular neuronitis occurs equally often with unilateral and bilateral lesions and is associated with diseases of a toxic-infectious and toxic-allergic nature (viral infections, acute respiratory infections, food poisoning, metabolic disorders, etc.), as well as with diseases of unknown origin. The duration of clinical manifestations ranges from 1 week to 3 months, after which the disease disappears without a trace and never recurrs.
Symptoms vestibular neuronitis
Symptoms of vestibular neuronitis are characterized by sudden, violent vestibular syndrome. Against the background of severe systemic dizziness, horizontal-rotatory spontaneous nystagmus of grade II-III is detected, directed to the affected side, changing its direction to the opposite after a few hours. Coordination of movements and balance are sharply impaired; the patient lies on the side corresponding to the side to which spontaneous nystagmus is directed (with all types of ocular two-component nystagmus, its direction is determined by the BK). Specific vestibular symptoms are accompanied by nausea and vomiting, photophobia. An attack can last for several hours and days, then its severity gradually decreases, and usually after 10-14 days spontaneous signs of vestibular dysfunction pass, however, for several weeks (up to 3 months), gradually normalizing unilateral hypofunction of the vestibular apparatus on the causal side remains. Cochlear function remains normal throughout the disease and afterwards.
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Diagnostics vestibular neuronitis
Diagnosis of vestibular neuronitis is extremely difficult in the first hours due to the rarity of this disease and the possibility of vestibular paroxysm occurring in many other pathological conditions. When making a diagnosis, they rely on anamnesis data (absence of similar attacks in the past, as well as diseases such as Meniere's disease, cervical osteochondrosis, inflammatory diseases of the ear, etc.). The age of the patient, usually young, is also of some importance.
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Treatment vestibular neuronitis
Treatment of vestibular neuronitis is mainly pathogenetic and symptomatic (antihistamines, tranquilizers, dehydration); in some cases, antiviral drugs are effective.