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Vestibular neuritis
Other Resources UpToDate PubMed

Vestibular neuritis

Contributors: Carolyn Zyloney MD, Benjamin L. Mazer MD, MBA, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed


Vestibular neuritis is idiopathic inflammation of the vestibular nerve (cranial nerve VIII). It typically causes a self-resolving syndrome of vertigo, nausea, and imbalance. Unlike labyrinthitis, it does not present with hearing loss or tinnitus because the cochlear portion of the 8th cranial nerve is unaffected.

Vestibular neuritis has an incidence of approximately 3.5:100 000 people per year. Although it can affect individuals of all ages, the peak incidence occurs in middle age. Its etiology is uncertain but may be associated with inner ear viral infections. Symptom onset is usually sudden and severe. Episodes may last a few days, then becomes less severe over weeks to months. Management involves symptomatic treatment with anticholinergics or antiemetics, physical therapy, and corticosteroids.


H81.20 – Vestibular neuronitis, unspecified ear

186738001 – Epidemic vertigo

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Labyrinthitis
  • Benign paroxysmal vertigo
  • Vertebrobasilar insufficiency
  • Labyrinthine infarction
  • Posterior circulation Cerebral stroke
  • Cerebellar stroke
  • Cerebellar ataxia (Acute cerebellar ataxia, Spinocerebellar ataxias)
  • Acute otitis media
  • Migraine headache
  • Labyrinthine fistula
  • Meniere disease
  • Trauma
  • Alcohol use disorder
  • Drug side effect (antihypertensives, aminoglycosides)
  • Malignancy (particularly central nervous system, tumor of cerebellopontine angle, bone)
  • Secondary syphilis
  • Autoimmune disease (eg, Systemic lupus erythematosus, Sarcoidosis)
  • Lyme disease
  • Hypoglycemia
  • Presyncope
  • Psychogenic dizziness
  • Multiple sclerosis

Best Tests

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Management Pearls

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Last Reviewed:02/07/2019
Last Updated:02/28/2019
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Vestibular neuritis
A medical illustration showing key findings of Vestibular neuritis : Nausea, Vomiting, Gait disturbance, Nystagmus, Vertigo
Copyright © 2024 VisualDx®. All rights reserved.