Vestibular neuronitis

Question 1

When does this disease usually occur?

Answer 1

Following a viral infection

Question 2

Symptoms?

Answer 2

• recurrent vertigo attacks lasting hours or days
• nausea and vomiting may be present
• horizontal nystagmus is usually present
• no hearing loss or tinnitus

Question 3

Differential diagnosis?

Answer 3

• viral labyrinthitis
• posterior circulation stroke: the HiNTs exam can be used to distinguish vestibular neuronitis from posterior circulation stroke

Question 4

Management for patients who experience chronic symptoms?

Answer 4

Vestibular rehabilitation

Question 5

Management to cause rapid relief for severe cases?

Answer 5

Buccal or intramuscular prochlorperazine

Question 6

Management for mild cases?

Answer 6

A short oral course of prochlorperazine, or an antihistamine (cinnarizine, cylicizine or promethazine)