- Vestibular neuronitis
DiseaseDisorder infobox
Name = Vestibular neuronitis
ICD10 = ICD10|H|81|2|h|80
ICD9 = ICD9|386.12Vestibular Neuronitis, also called "Vestibular neuritis", can be a paroxysmal, single attack of vertigo, a series of attacks, or a persistent condition which diminishes over two weeks. It may be associated with
nausea ,vomiting , and previous upperrespiratory tract infections. It generally has no auditory symptoms, unlikelabyrinthitis . Vestibular neuronitis may also be associated with eyenystagmus . It is caused by inflammation of thevestibular nerve , the nerve that connects theinner ear to thebrain .Diagnosis
In large part, the process involves ascertaining that the entire situation can be explained by a lesion in one or the other vestibular nerve. It is not possible on clinical examination to be absolutely certain that the picture of "vestibular neuritis" is not actually caused by a brainstem or cerebellar stroke, so mistakes are possible. Nevertheless, this happens so rarely that it is not necessary to perform MRI scans or the like very often. Signs of vestibular neuritis include spontaneous nystagmus and unsteadiness. One may notice that vision is disturbed or jumpy on looking to a particular side. This usually means that the opposite ear is affected -- it is called "Alexander's Law" and is due to asymmetric gaze evoked nystagmus . Occasionally other ocular disturbances will occur such as vertical double vision -- skew deviation. However if symptoms persist beyond one month, reoccur periodically, or evolve with time, testing may be proposed. In this situation, nearly all patients will be asked to undergo an audiogram and an ENG. An audiogram is a hearing test needed to distinguish between vestibular neuritis and other possible diagnoses such as Meniere's disease and Migraine. The ENG test is essential to document the characteristic reduced responses to motion of one ear. [cite web | url=http://www.dizziness-and-balance.com/disorders/unilat/vneurit.html | title=Vestibular neuritis and labyrinthitis | accessdate=2008-06-28]
Causes
Vestibular Neuronitis is felt to be caused by a viral infection of the balance nerve that runs from the inner ear to the brainches. It is not known which virus in particular causes this problem, and in fact many different viruses may be capable of infecting the balance nerve. Some patients will report having an upper respiratory infection (common cold) or a flu prior to the onset of the symptoms of vestibular neuronitis, others will have no viral symptoms prior to the vertigo attack. [cite web | url=http://www.uphs.upenn.edu/pennorl/bal_ves.htm | title=Vestibular Neuronitis and Migrainous Vertigo | accessdate=2008-06-27]
ymptoms
The main symptom of vestibular neuronitis is vertigo, which appears suddenly, often with nausea and vomiting. Vertigo usually lasts for several days or weeks. In rare cases it can take months to go away entirely. Vestibular neuronitis does not lead to loss of hearing. [cite web | url=http://www.cigna.com/healthinfo/aa75303.html | title=Vestibular Neuronitis | accessdate=2008-06-28]
Treatment
Viral infection of the vestibular nerve and/or labyrinth is believed to be the most common cause of vestibular neuronitis. Acute localized ischemia of these structures also may be an important cause. Especially in children, vestibular neuritis may be preceded by symptoms of a common cold. However, the causative mechanism remains uncertain. [cite web | url=http://www.emedicine.com/emerg/TOPIC637.HTM | title=Vestibular Neuronitis | author=Keith A Marill | accessdate=2008-06-28]
References
External links
* [http://www.dizziness-and-balance.com/disorders/unilat/vneurit.html]
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* [http://www.webmd.com/hw/ear_disorders/aa75306.asp WebMD]
* [http://www.pennhealth.com/ent/balance/hi/vestibular.html University of Pennsylvania]
* [http://www.dizziness-and-balance.com/disorders/unilat/vneurit.html On-line article on difference between Vestibular neuritis and Labyrinthitis]
* [http://www.dizzytimes.com/ Dizzytimes.com] Online Community for Sufferers of Vertigo and Dizziness
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