What Is Vestibular Neuritis?
Vestibular neuronitis is a sudden vertigo disease caused by the involvement of vestibular neurons, which is a type of peripheral neuritis. Lesions occur in the vestibular ganglia or the concentric part of the vestibular pathway. About two weeks before the illness, there was a history of upper respiratory virus infection. Vertigo and spontaneous nystagmus are the main clinical manifestations. Severe cases may be accompanied by nausea and vomiting, but without tinnitus and deafness; the duration of vertigo is short. It usually relieves gradually within a few days, and usually can be fully recovered within 2 weeks. A few patients may have dizziness, dizziness, and instability of varying degrees for a short period of time, which lasts for several days or months, and the symptoms worsen during activity.
Basic Information
- English name
- vestibular neuronitis
- Visiting department
- Neurology
- Common causes
- Viral infection, stimulation of vestibular nerve, focal factors
- Common symptoms
- Dizziness and Spontaneous Nystagmus
Causes of vestibular neuronitis
- Virus infection
- Herpes simplex and shingles virus titers were significantly increased after the illness.
- 2. Vestibular nerves are stimulated
- Vestibular nerves suffered from vascular compression or arachnoid adhesions, and even caused by hypoxic degeneration of the inner auditory canal, which triggered nerve discharge and caused the disease.
- 3. Lesion factors
- There may be an autoimmune response.
- 4. Diabetes
- Diabetes can cause degeneration and atrophy of vestibular neurons, leading to repeated vertigo attacks. After the vestibular nerve was cut off in some patients, pathological examination revealed that the vestibular nerve had arc standing or scattered degenerative changes and regeneration phenomena. Nerve fibers were reduced, ganglion cell vacuoles were formed, and intra-nerve collagen deposition was increased.
Vestibular neuronitis clinical manifestations
- Single episode
- Sudden and intense onset of rotational vertigo and ataxia or imbalance, with obvious nausea and vomiting, horizontal rotational nystagmus, fast to the healthy side, no signs of hearing and central nervous system disease. Dizziness lasts for several days or weeks (not more than 1 to 3 weeks), usually progressively reduced after a few days, and the signs completely disappear after 6 months.
- 2. Multiple episodes
- The clinical manifestations are recurrent vertigo or a disorder of balance and instability, without signs of hearing and central nervous system disease. Vertigo is not as intense as the single author. This chronic form occurs because the vestibular nerve is only partially atrophied, or because of a physiological disorder of nerve function.
Vestibular neuronitis
- 1. Dizziness should be tested for anemia, hypoglycemia, and endocrine disorders.
- 2. Cerebrospinal fluid examination is particularly important for the determination of intracranial infectious diseases.
- 3. Suspected auditory neuroma should take plain audiographs; cervical vertigo can take cervical spine films; EEG is helpful for the diagnosis of vertigo epilepsy; consider intracranial space occupying lesions, cerebrovascular diseases, etc. as the skull CT or MRI. Brainstem auditory evoked potentials are helpful to help localize the diagnosis of vestibular neuropathy.
Vestibular neuronitis diagnosis
- In addition to clinical manifestations, hearing examinations, electroencephalograms of cold and heat tests, and skull MRI should be used to assist diagnosis. Special attention should be paid to internal auditory canal examinations to rule out other diagnostic possibilities, such as cerebellopontine angle tumors, brain stem Bleeding or infarction.
Vestibular neuronitis treatment
- General treatment
- Bed rest to avoid head and neck movements and sound and light stimulation
- Symptomatic treatment
- For the dizziness symptoms caused by vestibular damage, sedatives and tranquilizers should be given. Those with severe dizziness and vomiting can be injected with promethazine hydrochloride or diazepam. If the symptoms are not obvious, the above treatment can be repeated as appropriate. After dizziness is reduced, promethazine, diazepam, or flunarizine (sibilin) can be continued. At the same time, vitamin B 1 , B 6 , niacin (nicotinic acid) or anisodamine can be taken orally, and vitamin B 12 can be injected intramuscularly. Hyperbaric oxygen therapy is available when necessary.
- 3. Acute onset of vertigo
- Symptoms can be controlled according to the treatment of Meniere's disease. For prolonged vomiting, intravenous fluid replacement and electrolyte supplementation and supportive treatment are necessary.
- 4. Vestibular rehabilitation exercise.
- 5. Hormone therapy
- Prednisone (prednisone) is taken orally with potassium salts.