Vestibular Neuritis

What is vestibular neuritis?

Vestibular neuritis is a disorder that affects the vestibulocochlear nerve of your inner ear. This nerve sends information about your balance and head position from your inner ear to your brain. When this nerve becomes inflamed or swollen, it interrupts the way your brain reads information. This results in dizziness, vertigo and other balance-related symptoms.

How rare is vestibular neuritis?

Vestibular neuritis affects around 4 out of every 100,000 people in the United States. It’s the third most common cause of peripheral vertigo. People with peripheral (inner ear) vertigo have balance issues but can typically still walk.

Vestibular neuritis can occur in people of all ages, but it’s less common in children.

What are the symptoms of vestibular neuritis?

Typically, people with vestibular neuritis go through an acute phase and a chronic phase. In most cases, this means sudden, severe symptoms for about one week, followed by milder symptoms that last anywhere from a few weeks to several months. It’s rare, but some people develop long-term vestibular neuritis symptoms which last for years.

Acute vestibular neuritis

The initial phase of vestibular neuritis lasts up to a few days. Symptoms vary and may include:

• Sudden, severe vertigo (a spinning sensation).
• Intense dizziness (feeling lightheaded or unsteady).
• Severe balance issues.
• Nausea and vomiting.
• Difficulty concentrating.
• Severe motion sensitivity.
• Nystagmus, a condition where you can’t control your eye movements.

Chronic vestibular neuritis

The chronic phase of vestibular neuritis can last anywhere from a few weeks to several months and may include symptoms such as:

• Lightheadedness.
• Mild dizziness with head and body movements.
• Mild nausea.
• Some difficulty walking, especially in busy environments.
• A feeling of fullness in your ears.
• Mild motion sensitivity.
• Anxiety.

Keep in mind that vestibular neuritis symptoms vary from person to person. Your symptoms will depend on several factors, including the exact cause, the area of nerve damage and your medical history.

What triggers vestibular neuritis?

Experts believe vestibular neuritis results from viral infections that start in your inner ear or begin somewhere else in your body, like chickenpox or viral hepatitis.

Is vestibular neuritis contagious?

The condition itself isn’t contagious. In other words, you can’t catch vestibular neuritis from someone else who has it. But you can pass the viruses that cause vestibular neuritis to other people.

What are the risk factors for vestibular neuritis?

Having a viral infection is the main risk factor for vestibular neuritis. Examples of viral infections include:

• Flu (influenza).
• COVID-19.
• Herpes simplex virus type 1 (the same virus that causes cold sores).
• Hepatitis.
• Polio.
• Measles.
• Mumps.

What are the complications of vestibular neuritis?

For many people, vestibular neuritis symptoms improve in a week or two. But about half of all people with the condition develop chronic, long-lasting symptoms like unsteadiness, dizziness or spatial disorientation (the inability to determine your body position relative to your surroundings). In extreme cases, people may have permanent hearing loss or damage to their inner ear.

How does an ENT diagnose vestibular neuritis?

In most cases, an otolaryngologist (ENT) diagnoses vestibular neuritis. Some people may also need to see a neurologist (a doctor who specializes in the brain and nervous system) or an audiologist (a hearing specialist).

First, your healthcare provider will rule out any other potential health conditions, such as:

• Stroke.
• Head injury.
• Brain tumor.
• Migraine headaches.

To do this, they may request imaging tests. This usually includes an MRI (magnetic resonance imaging) with dye (contrast agent).

What tests can help diagnose vestibular neuritis?

Your healthcare provider may also use the following tests to confirm your diagnosis:

• Hearing tests.
• Vestibular test battery.
• Tests to locate areas of damage on your vestibular nerve.

What’s the cure for vestibular neuritis?

The main goal of vestibular neuritis treatment is to manage your symptoms. To do this, your healthcare provider may recommend:

• Medications (antivirals and drugs to treat nausea, dizziness and inflammation).
• Vestibular neuritis exercises (physical therapy).

Medications for vestibular neuritis

Your healthcare provider may use a variety of medications to ease your vestibular neuritis symptoms, such as:

• Anti-nausea medications.
• Drugs to reduce dizziness.
• Drugs to reduce inflammation.
• Antiviral medications.

Anti-nausea medications

Drugs to reduce nausea include:

• Ondansetron (Zofran®).
• Metoclopramide (Reglan®).

People with severe nausea and vomiting may need to stay in the hospital. There, healthcare providers will give you IV fluids to address dehydration.

Drugs to reduce dizziness

Drugs to reduce dizziness include:

• Meclizine (Antivert®).
• Diazepam (Valium®).
• Compazine and lorazepam (Ativan®).

Drugs to reduce dizziness are vestibular suppressants. You shouldn’t use vestibular suppressants longer than three days.

Drugs to reduce inflammation

Healthcare providers may also recommend corticosteroids to reduce inflammation in your vestibular nerve.

Antiviral medications

If a herpes virus caused vestibular neuritis, your healthcare provider may recommend antiviral medicine like acyclovir.

Vestibular neuritis exercises

If balance and dizziness problems last longer than a few weeks, your healthcare provider may recommend vestibular rehabilitation therapy. The goal of this program is to retrain your brain to adapt to the changes you experience.

As the first step in this program, a vestibular physical therapist evaluates the parts of your body that affect balance. These areas include your:

• Legs.
• Eyes.
• Ears.

Your provider will design an exercise program tailored to your specific needs based on the results of the evaluation.

Can I prevent vestibular neuritis?

Because viruses cause vestibular neuritis, you can’t always prevent the condition. However, you can reduce your risk by making sure you’re up to date on all of your vaccines.

How long does vestibular neuritis last?

It depends on your unique situation. Recovery times vary greatly depending on the severity of your condition and where on your vestibular nerve the damage occurred.

Some people may recover in just one week. Others may have lingering symptoms that last weeks, months or even years.

What’s the outlook for people with vestibular neuritis?

People with vestibular neuritis usually make a full recovery within a few weeks. But symptoms may linger for some people. If your symptoms aren’t improving, talk to your healthcare provider about additional treatment options.

When should I see my healthcare provider?

Call your healthcare provider anytime you develop vestibular neuritis symptoms like severe vertigo, dizziness or balance issues. If you’ve already undergone vestibular neuritis treatment but your symptoms aren’t improving, let your provider know.

What questions should I ask my healthcare provider?

If you have vestibular neuritis, here are some questions you may want to ask your healthcare provider:

• What do you think caused my condition?
• How badly is my vestibular nerve damaged?
• What are some things I can do to ease my symptoms?
• Should I take any medication?
• Could I benefit from physical therapy?
• How long do you think it’ll be before I recover?

Vestibular neuritis vs. labyrinthitis: What’s the difference?

Vestibular neuritis and labyrinthitis are closely related disorders that cause similar symptoms. While vestibular neuritis involves inflammation of the vestibular nerve, labyrinthitis refers to inflammation of the labyrinth — the part of your inner ear that contains organs that help with balance and hearing.

Vestibular neuritis vs. BPPV: What’s the difference?

Vestibular neuritis and BPPV (benign paroxysmal positional vertigo) cause many of the same symptoms. But these are very different conditions.

While vestibular neuritis results from an inflamed vestibular nerve, BPPV happens when tiny crystals (otoconia) in your inner ear become displaced. Otoconia generally stay in your utricle (a fluid-filled cavity in your inner ear). But these tiny crystals can become dislodged and travel to your semicircular canals (fluid-filled tubes that help with balance). When this occurs, it can result in vertigo, dizziness and balance issues.

Can vestibular neuritis come back?

In about 95% of people, having vestibular neuritis is a one-time experience. Most people fully recover. However, recurrence (return) is possible.

Can COVID-19 cause vestibular neuritis?

Yes. Like many other viruses, COVID-19 can result in inner ear issues such as vestibular neuritis. If you’re experiencing worrisome symptoms, contact your healthcare provider right away.

A note from Cleveland Clinic

Vestibular neuritis is an inner ear disorder that results in severe vertigo, dizziness and balance issues. It can come on suddenly and last anywhere from one week to several months — and in some cases, even years. Vestibular neuritis causes include viruses that affect your inner ear or begin somewhere else in your body. Most people with vestibular neuritis improve within a few weeks. If your symptoms don’t go away, talk to your healthcare provider. They can help find a treatment that works best for you.