Vestibular neuritis and labyrinthitis
INTRODUCTION
Vestibular neuritis is also known as vestibular neuronitis, labyrinthitis, neurolabyrinthitis, and acute peripheral vestibulopathy [1]. A group of leading international experts has proposed the term "acute unilateral vestibulopathy" (AUVP) as the preferred name for this condition [2]. It is a self-limited disorder, and most patients recover completely. 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 "Causes of vertigo".)
PATHOPHYSIOLOGY
Vestibular neuritis is generally understood to be a viral or postviral inflammatory disorder affecting the vestibular portion of the eighth cranial nerve [2]. There are few 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 [3-6]. One advanced magnetic resonance imaging (MRI) study revealed a pattern of enhancement consistent with an inflammatory process in 20 of 29 patients with vestibular neuritis [7].CLINICAL MANIFESTATIONS
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.To continue reading this article, you must sign in with your personal, hospital, or group practice subscription.
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