Vestibular neuritis and labyrinthitis
- Joseph M Furman, MD, PhD
Joseph M Furman, MD, PhD
- University of Pittsburgh
- Section Editors
- Michael J Aminoff, MD, DSc
Michael J Aminoff, MD, DSc
- Editor-in-Chief — Neurology
- Section Editor — Medical Neurology
- Professor of Neurology
- University of California, San Francisco School of Medicine
- Daniel G Deschler, MD, FACS
Daniel G Deschler, MD, FACS
- Section Editor — Otorhinolaryngology
- Professor of Otology and Laryngology
- Harvard Medical School
Vestibular neuritis is also known as vestibular neuronitis, labyrinthitis, neurolabyrinthitis, and acute peripheral vestibulopathy. It is a benign disorder, self-limited, and associated with a complete recovery in most patients. Nonetheless, its symptoms of vertigo, nausea, vomiting, and gait impairment can be disabling in the short term.
Vestibular neuritis also shares clinical features with less benign disorders, particularly acute vascular lesions of the central nervous system, from which it must be accurately differentiated in order to avoid morbidity and mortality.
This topic will review the pathophysiology, clinical manifestations, diagnosis, and treatment of vestibular neuritis. The evaluation and differential diagnosis of vertigo are discussed separately. (See "Evaluation of the patient with vertigo" and "Pathophysiology, etiology, and differential diagnosis of vertigo".)
Vestibular neuritis is generally understood to be a viral or postviral inflammatory disorder affecting the vestibular portion of the eighth cranial nerve. This pathophysiological mechanism is not necessarily accurate . There are little pathologic data to support this mechanism in patients with this disorder, and a history of a preceding viral illness is elicited in less than one-half of patients [2-4].
Vestibular neuritis, also known as vestibular neuronitis and labyrinthitis, represents an acute, spontaneous, peripheral vestibular ailment, characterized by the rapid onset of severe vertigo with nausea, vomiting, and gait instability.
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