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.
Vestibular neuritis
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Synopsis

Codes
ICD10CM:
H81.20 – Vestibular neuronitis, unspecified ear
SNOMEDCT:
186738001 – Epidemic vertigo
H81.20 – Vestibular neuronitis, unspecified ear
SNOMEDCT:
186738001 – Epidemic vertigo
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Differential Diagnosis & Pitfalls
- Labyrinthitis
- Benign paroxysmal positional vertigo
- Vertebrobasilar insufficiency
- Labyrinthine infarction
- Posterior circulation ischemic stroke
- Cerebellar hemorrhage
- Cerebellar ataxia (acute cerebellar ataxia, spinocerebellar ataxias)
- Acute otitis media
- Vestibular migraine
- Perilymphatic fistula
- Meniere disease
- Trauma
- Alcohol use disorder
- Drug side effect (antihypertensives, aminoglycosides)
- Malignancy (particularly central nervous system, tumor of cerebellopontine angle, bone)
- Syphilis
- Autoimmune disease (eg, systemic lupus erythematosus, sarcoidosis)
- Lyme disease
- Hypoglycemia
- Presyncope
- Psychogenic dizziness
- Multiple sclerosis
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Last Reviewed:02/07/2019
Last Updated:02/28/2019
Last Updated:02/28/2019