Vestibular Neuritis

Vestibular neuritis is an inner ear disorder that affects the vestibulocochlear nerve. This nerve receives information from your inner ear about the position and movement of your head. It sends that information to your brain, which uses the information to help you maintain your sense of balance.

An infection that causes inflammation in your inner ear can make this nerve swell or become inflamed. When that happens, your brain can’t read the information your nerve sends, and you have dizziness, vertigo or other balance issues.

This condition affects about 4 in every 100,000 people in the U.S. Anyone may develop vestibular neuritis, but it’s more common in adults than in children. Treatment often involves medication to ease your symptoms.

Symptoms of vestibular neuritis

The symptoms can vary depending on whether you’re experiencing the acute or chronic phase of vestibular neuritis.

The acute phase can last up to a week and cause symptoms like:

• Sudden, severe vertigo, which is a spinning sensation
• Intense dizziness, feeling lightheaded or unsteady even when sitting still
• Severe balance issues
• Nausea and vomiting
• Difficulty concentrating
• Severe sensitivity to motion
• Nystagmus, when you can’t control your eye movements

The chronic phase may last for a few weeks up to several months. It can cause symptoms like:

• Lightheadedness
• Mild dizziness when you move your head or body
• Mild nausea
• Difficulty walking, especially if you’re in a busy area
• A feeling of fullness in your ears
• Mild sensitivity to motion
• Anxiety

Vestibular neuritis causes

Experts don’t know the exact cause but believe that viral infections may trigger the condition. The infection may be in your inner ear. But it can spread to your inner ear from another part of your body. Either way, a viral infection may cause inflammation that affects your vestibulocochlear nerve. Infections that may affect this nerve include:

• Colds and flu
• COVID-19
• Herpes simplex virus type 1
• Hepatitis
• Polio
• Measles
• Mumps

Is this condition contagious?

No, you can’t catch vestibular neuritis from someone else. But you can catch a virus that may cause the nerve to swell or become inflamed.

Complications of vestibular neuritis

The effects of vestibular neuritis may cause long-term symptoms, like dizziness or unsteadiness. You may have spatial disorientation, when you can’t determine your body’s position relative to your surroundings.

This condition rarely involves hearing loss.

How doctors diagnose vestibular neuritis

A healthcare provider will ask about your symptoms. They may do an MRI with contrast to rule out other causes, like:

• Stroke
• Brain tumor
• Head injury
• Migraine headaches

After ruling out other causes, your provider may refer you to an audiologist. That provider may do:

• Hearing tests
• Vestibular test battery
• An MRI to check for damage to your vestibulocochlear nerve

How is vestibular neuritis treated?

Treatment may be a combination of medication and physical therapy to manage your symptoms. Your healthcare provider may prescribe:

• Anti-nausea medications, like ondansetron (Zofran®) or metoclopramide (Reglan®)
• Medications for dizziness, like meclizine (Antivert®), diazepam (Valium®), or compazine and lorazepam (Ativan®) for the acute phase
• Corticosteroids for inflammation
• Antiviral medications if herpes virus is the cause

They may recommend vestibular rehabilitation therapy if your symptoms continue. This treatment involves exercises that help you manage dizziness and balance issues.

When should I see my healthcare provider?

Talk to a healthcare provider if you have dizziness, lightheadedness or balance issues that happen for no obvious reason and don’t improve. If you have vestibular neuritis, talk to your provider if treatment doesn’t ease your symptoms or if they get worse.

What can I expect if I have vestibular neuritis?

Some people may recover in just one week. Others may have lingering symptoms that last weeks, months or even years. If your symptoms aren’t improving, talk to your healthcare provider about additional treatment options.

Vestibular neuritis can come back, but that doesn’t happen very often.

What’s the difference between vestibular neuritis and labyrinthitis?

Vestibular neuritis happens when something affects your vestibulocochlear nerve. With labyrinthitis, there’s inflammation in your labyrinth. This is the part of your inner ear that contains organs that support hearing and balance.

What’s the difference between vestibular neuritis and BPPV?

Vestibular neuritis and benign paroxysmal positional vertigo (BPPV) cause many of the same symptoms. But these are very different conditions. BPPV happens when tiny crystals (otoconia) in your inner ear move from a fluid-filled cavity in your inner ear to fluid-filled tubes that help with balance.