Are you suddenly dizzy? Let's learn about Vestibular Neuritis!

What if you were at a loss and suddenly felt dizzy like a madman? You could barely stand up, you could feel yourself shaking, you could feel yourself vomiting... This is a really scary experience. The condition that can cause such sudden, severe dizziness is what we're talking about today, Vestibular Neuritis. Don't worry, we'll keep everything simple.

What exactly is Vestibular Neuritis?

Simply put, this is an inflammation or swelling of a nerve that is connected to our inner ear. There is a very special nerve in our inner ear, called the ``Vestibulocochlear nerve.`` The main function of this nerve is to send information to the brain about our body's balance and the position of our head when we turn it .

Imagine, when you walk, turn your head, or run, you don't fall because this nerve sends accurate information to the brain. Now, in `Vestibular Neuritis`, when this nerve becomes inflamed, the signals going to the brain are disrupted. It's like a broken telephone line. Then the brain can't understand how the body is positioned or how it's moving. That's when we start to feel severe dizziness (vertigo) , spinning, and loss of balance.

Although this condition can occur in people of any age, it is somewhat less common among young children.

What are the symptoms of this? How does it feel?

This condition usually comes in two stages. First, there is a phase with severe symptoms that start suddenly, and then there is a phase where the symptoms subside a little.

1. Acute Phase (sudden onset)

This is the most difficult time. This can last for a few days, maybe a week. The symptoms come on suddenly, very badly.

2. Chronic Phase

After the acute phase is over, symptoms may subside for a few weeks or months. During this time, the symptoms you experience will be slightly different.

Let's clearly distinguish the symptoms of these two stages.

Why is this happening? What is the reason?

Doctors believe that the main cause of Vestibular Neuritis is a viral infection . This virus can directly affect the inner ear, or it can be a side effect of a viral infection elsewhere in the body.

Just like when we get a cold, our nose and throat swell, some viruses can cause the nerves in our inner ear that are responsible for balance to swell. That's what's happening here.

What types of viruses can cause this?

• Flu (Influenza)
• Covid-19 (COVID-19)
• Herpes virus (Herpes simplex virus - the virus that causes cold sores)
• Hepatitis
• Polio
• Measles
• Mumps

Is this disease contagious?

No. Vestibular Neuritis is not contagious. This means that you cannot get it from being around someone who has it. However, the virus that causes it can be transmitted . For example, if someone gets Vestibular Neuritis from the flu virus, that person can pass the flu virus on to someone else.

How does a doctor recognize this?

If you have severe dizziness like this, the first thing you should do is see a doctor. This is usually an otolaryngologist (ENT) who specializes in ear, nose, and throat problems. Sometimes, you may need to see a neurologist or audiologist.

The first and most important thing the doctor will do is to make sure that other serious medical conditions are not the cause , as these symptoms can also occur in other serious illnesses.

What diseases are ruled out first?

• Stroke: This is the most dangerous. It occurs when a blood vessel supplying blood to the brain becomes blocked or bursts.
• Head injury.
• Brain tumor.
• Migraine headaches.

To make sure these things are not there, your doctor may ask you to do something like an MRI (Magnetic Resonance Imaging) scan.

After ruling out those things, several more tests are performed to confirm `Vestibular Neuritis`.

• Hearing tests.
• Special tests that test balance (Vestibular test battery).

What are the treatments for this?

The main goal of treating vestibular neuritis is to control your symptoms and help you recover quickly.

There are two main treatments for this:

1. Medications

2. Vestibular rehabilitation therapy

Types of medications given

• Medications for nausea and vomiting: Medications such as ``Ondansetron (Zofran®)`` are given for this. If the vomiting is very severe, you may need to be hospitalized and given saline to prevent dehydration.
• Medicines to reduce dizziness: Medicines like `Meclizine` and `Diazepam (Valium®)` are given. However, doctors say that it is not good to use these for more than three days in a row . Because if you continue to take them, it may be too late for the brain to adjust to this new state.
• Medicines that reduce inflammation: Medicines called `Corticosteroids` are given to reduce swelling in the nerve.
• Antiviral medication: If there is a suspicion that this is caused by the herpes virus, an antiviral such as Acyclovir can be given.

Vestibular Rehabilitation Therapy

Some people have dizziness and loss of balance for more than a few weeks. This is where physical therapy exercises become very important.

This involves training your brain to adjust to this new situation and regain balance. A specially trained physiotherapist will examine the function of your eyes, ears, and legs and create a series of exercises that are right for you. Doing these exercises correctly will help you recover quickly.

How long will it take for this condition to heal?

There is no exact time frame for this. It varies greatly from person to person. Some people recover completely in about a week. Others may have symptoms for months, and in rare cases, even years. It depends on the extent of the nerve damage and how your body responds to it.

The best part is that most people recover completely within a few weeks. If your symptoms don't improve or persist, talk to your doctor about other treatment options.

Difference Between Vestibular Neuritis and Similar Conditions

There are two other conditions that have similar symptoms. Let's learn a little about the differences between them.

• Vestibular Neuritis vs. Labyrinthitis: These two are very similar. In `Vestibular Neuritis`, only the nerve related to balance is inflamed. However, in `Labyrinthitis`, both the part related to balance and the part related to hearing are inflamed. Therefore, a person with `Labyrinthitis` may experience hearing loss or ringing in the ears (tinnitus) along with dizziness.
• Vestibular Neuritis vs. BPPV: BPPV (Benign Paroxysmal Positional Vertigo) is also a common condition that causes dizziness. However, it is not caused by a nerve. BPPV is caused by small calcium crystals in our inner ear that become dislodged and move to another location. In this case, dizziness occurs especially when we turn our head to one side or when we roll over in bed .