Vestibularneurit

Vestibular neuritis, also known as vestibular neuropathy, is an acute inflammatory disorder of the vestibular nerve that causes sudden prolonged vertigo. Hearing is typically preserved, which helps distinguish it from labyrinthitis.

Most patients describe a sudden episode of vertigo that lasts days to weeks, often with nausea, vomiting, imbalance, and gait disturbance. Nystagmus is common, and a head impulse test is often positive on the affected side. Oscillopsia may occur when looking at moving objects.

Most cases are presumed to follow a viral infection or an immune-mediated process that inflames the vestibular nerve. The condition causes unilateral vestibular hypofunction, with reduced input from the affected ear, while the cochlea remains intact.

Diagnosis relies on clinical features and the exclusion of other causes. Audiometry is normal. Magnetic resonance imaging is typically performed to rule out central lesions. Vestibular testing (caloric testing or rotary chair) shows reduced function on the affected side. The differential diagnosis includes labyrinthitis (hearing loss or tinnitus present), Menière disease, and cerebrovascular events.

Treatment focuses on symptom control and rehabilitation. In the acute phase, antiemetics may be used; short-term vestibular suppressants can be considered but should be limited. Corticosteroids have been studied; some evidence suggests a modest benefit if started early, but findings are not unequivocal. Vestibular rehabilitation therapy promotes compensation and improves long-term outcomes. Most patients recover over weeks to months, but some experience persistent imbalance or spatial disorientation. Recurrences are uncommon.