Vestibular Neuronitis

Updated: Nov 22, 2016
  • Author: Keith A Marill, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Overview

Background

Vestibular neuronitis may be described as acute, sustained dysfunction of the peripheral vestibular system with secondary nausea, vomiting, and vertigo. As this condition is not clearly inflammatory in nature, neurologists often refer to it as vestibular neuropathy.

Although vestibular neuronitis and labyrinthitis may be closely related in some cases, vestibular neuronitis is generally distinguished from labyrinthitis by preserved auditory function.

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Pathophysiology

Its etiology remains largely unknown, yet vestibular neuronitis appears to be a sudden disruption of afferent neuronal input from 1 of the 2 vestibular apparatuses. This imbalance in vestibular neurologic input to the central nervous system (CNS) causes symptoms of vertigo. At least some cases are thought to be due to reactivation of latent herpes simplex virus type 1 in the vestibular ganglia.

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Epidemiology

Frequency

United States

Dizziness is the primary ED complaint in 3.3% of US ED visits, and approximately 5.6% of these patients are diagnosed with vestibular neuritis or labyrinthitis. Thus, the annual incidence of these two diagnoses in US EDs is approximately 150,000 patients. [1]

Mortality/Morbidity

Most patients experience complete recovery within a few weeks. A minority have recurrent vertiginous episodes following rapid head movement for years after onset. [2]

Sex

Studies have shown no consistent male or female predominance. [3]

Age

This syndrome occurs most commonly in middle-aged adults; mean age of onset is 41 years. [3]

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