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Vestibular Neuronitis
Last reviewed: 23.04.2024
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Vestibular neuronitis - an acute (viral) lesion of the vestibular ganglion, vestibular nuclei and other retrolabirint structures, isolated into an independent nosological form in 1949 by the American otolaryngologist by C.Hallpike. The disease is characterized by an acute attack of vestibular dysfunction without cochlear disorders, equally manifested in males and females, most often between the ages of 30-35 years. Vestibular neuronitis is equally common in unilateral and bilateral lesions and is associated with toxic-infectious and toxic-allergic diseases (viral infections, acute respiratory infections, food poisoning, metabolic disorders, etc.), as well as diseases of unknown nature. The duration of clinical manifestations ranges from 1 week to 3 months, after which the disease disappears without a trace and never recurs.
Symptoms of the vestibular neuronitis
Symptoms of vestibular neuronitis are characterized by a sudden violent vestibular syndrome. Against the background of severe systemic vertigo, a horizontal rotary spontaneous nystagmus of the II-III degree is detected, directed to the diseased side, changing its direction to the opposite in a few hours. The coordination of movements, balance is sharply violated; the patient lies on the side corresponding to the side to which spontaneous nystagmus is directed (for all types of ocular two-component nystagmus without exception, its direction is determined by BC). Specific vestibular symptoms are accompanied by nausea and vomiting, photophobia. The attack may last for several hours and days, then its severity gradually decreases, and usually after 10-14 days the spontaneous signs of vestibular dysfunction disappear, but within a few weeks (up to 3 months) the one-sided hypofunction of the vestibular apparatus gradually normalizes on the causal side. Cochlear function throughout the disease and after it remains normal.
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Diagnostics of the 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 in many other pathological conditions. When making a diagnosis, they are based on the data of anamnesis (the absence of similar attacks in the past, as well as diseases such as Meniere's disease, cervical osteochondrosis, inflammatory diseases of the ear, etc.). A certain value is also the age of the patient, usually young.
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Treatment of the vestibular neuronitis
Treatment of vestibular neuronitis is mainly pathogenetic and symptomatic (antihistamines, tranquilizers, dehydration), in some cases, antiviral drugs are effective.