Imagine when you are at a loss, and suddenly the whole world starts spinning around you... as if the world is just spinning. You can't get out of bed, you feel dizzy when you stand up, you feel nauseous, you vomit. Have you ever had an experience like this? This condition that suddenly scares many people is called Vestibular Neuritis, which we are going to talk about today. This may sound a bit serious, but if you understand it properly, it is a condition that can be managed.
Simply put, what is Vestibular Neuritis?
To understand this, let's first learn about a little magic that happens inside our ears. There is a very important nerve in our inner ear. It is called the vestibulocochlear nerve . This nerve has two main functions: one is to carry what we hear to the brain, and the other is to control our body's balance . When we shake our heads, walk, or run, this nerve sends information to the brain about our position.
Vestibular Neuritis is a condition in which the part of this nerve that controls balance becomes inflamed or damaged due to a viral infection. Imagine that your way to the office suddenly becomes confusing. Then you can't get to the office right away, right? Similarly, when this nerve becomes inflamed, the signals about "balance" from the inner ear to the brain get confused. Because the brain doesn't get the right information, it thinks we're spinning. That's why we feel like the whole world is spinning.
The important thing is that Vestibular Neuritis usually does not affect hearing. If you experience dizziness along with hearing loss, it could be another condition, such as Labyrinthitis. We'll talk about that later.
What are the symptoms of this condition?
Symptoms of vestibular neuritis usually come in two phases: an acute phase that comes on suddenly, and a chronic phase that lasts for a while.
| Symptom stage | Expected features |
|---|---|
| Acute Phase (Usually lasts a few days) |
|
| Chronic Phase (From a few weeks to a few months) |
|
These symptoms do not occur in the same way for everyone. Some people may only experience severe symptoms and then recover. Others may have mild symptoms for months.
Why is this happening? What is the reason?
Most often, 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 virus that has developed elsewhere in the body.
Simply put, even a virus like the common cold or flu that we all get can cause this.
Types of viruses that increase the risk of this:
- Flu (Influenza)
- Covid-19 (COVID-19)
- Herpes simplex virus (Herpes simplex virus type 1 - the virus that causes cold sores)
- Hepatitis
- Measles
- Mumps
Importantly, Vestibular Neuritis is not contagious from one person to another. However, the virus that causes it (e.g., the flu virus) can be contagious.
How do you find this, Doctor?
If you have the symptoms mentioned above, the first thing you should do is see a doctor . You will likely be referred to an ear, nose, and throat specialist (ENT Surgeon) .
The doctor will first ask you about your symptoms. Then, make sure you don't have any other serious medical conditions that could be causing these symptoms. Sudden dizziness and loss of balance can also be a sign of something like a stroke , a brain tumor, or a head injury.
Therefore, to rule these things out, the doctor may order tests like these:
- MRI scan: An MRI, which is performed using a contrast agent, can clearly see the condition of the brain and nerves.
- Hearing tests: Hearing is checked, as hearing is usually good in vestibular neuritis.
- Special tests for balance (Vestibular test battery): These tests help determine how impaired your balance is and where the nerve damage is.
What are the treatments for this?
The main goal of treating vestibular neuritis is to control symptoms and help you get back to normal quickly.
1. Medications
In severe cases, the doctor may prescribe medications such as:
- Medicines for vomiting and nausea: Medicines such as Ondansetron (Zofran®) and Metoclopramide (Reglan®). If the vomiting is very severe, you may need to be hospitalized and given saline to stop dehydration.
- Medications to reduce dizziness: Medications such as Meclizine (Antivert®) and Diazepam (Valium®) are called vestibular suppressants. However, they are not recommended for use for more than three days , as taking them longer than that can reduce the brain's ability to naturally adjust to this condition.
- Medications that reduce nerve swelling: Medications called corticosteroids reduce nerve swelling and help it heal faster.
- Antiviral medications: If there is a suspicion that this is caused by something like the herpes virus, antiviral medications such as Acyclovir can be given.
2. Special exercises (Vestibular Rehabilitation Therapy)
If dizziness and imbalance persist for more than a few weeks, your doctor may refer you to a special exercise program called Vestibular Rehabilitation Therapy (VRT) .
This is a wonderful thing. Simply put, it "trains" your brain to re-establish balance. It teaches your brain how to use your eyes and other parts of your body to maintain balance, getting used to the confusing signals coming from your nerves.
A trained physical therapist will help you with this. He or she will teach you a series of simple exercises that are specific to you.
What is the difference between Vestibular Neuritis, Labyrinthitis and BPPV?
Many people confuse these three conditions, as the main symptom of all three is dizziness (vertigo). However, they are different.
| Disease status | Main reason and difference |
|---|---|
| Vestibular Neuritis | Swelling of the part of the vestibular nerve that controls balance. Hearing is not affected. |
| Labyrinthitis | The entire labyrinth of the inner ear swells. This causes dizziness, along with hearing loss or ringing in the ears. |
| BPPV (Benign Paroxysmal Positional Vertigo) | Small calcium balls (otoconia) in the inner ear become dislodged and move to where they shouldn't be. The dizziness only occurs when the head is moved to a certain side (e.g., when rolling over in bed) and goes away within a few seconds. |
How long will this condition last? Can it occur again?
It's hard to give a definitive answer to this. It varies from person to person.
- For some: Complete recovery within a week or two.
- For others: Mild symptoms (like slight imbalance) may persist for several months.
- Very rare: Some people may have symptoms for years.
The good news is that 95% of people only get it once in their lifetime. The chance of it happening again is very low.
When should you see a doctor?
If you have symptoms such as sudden severe dizziness, loss of balance, or vomiting, see a doctor or go to the Emergency Department (ETU) immediately. It is important to rule this out first, as these could be signs of a more serious condition, such as a stroke.
If your symptoms do not improve after treatment, don't forget to tell your doctor about it.
Take-Home Message
- Vestibular Neuritis is inflammation of the nerve that controls balance in the inner ear, caused by a viral infection.
- The main symptoms are sudden, severe dizziness (vertigo), nausea, and inability to walk. Hearing is usually not affected.
- If symptoms like these occur, it is imperative to seek immediate medical advice to rule out serious conditions such as stroke.
- Most people recover completely within a few weeks with medication and special exercises (Vestibular Rehabilitation).
- This condition is not contagious, and the chance of developing it more than once in a lifetime is very low.
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