Schwannoma

Vestibular neuronitis

Vestibular neuronitis is a cause of vertigo that often develops following a viral infection.

Features

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

Differential diagnosis

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

Management

• buccal or intramuscular prochlorperazine is often used to provide rapid relief for severe cases
• a short oral course of prochlorperazine, or an antihistamine (cinnarizine, cyclizine, or promethazine) may be used to alleviate less severe cases
• vestibular rehabilitation exercises are the preferred treatment for patients who experience chronic symptoms