Vestibular neuronitis is an acute dysfunction of the vestibular system in the inner ear. An imbalance in neuronal input from the two vestibular apparatuses appears to be the cause. Most cases of vestibular neuronitis resolve completely within a few weeks, but some patients have recurrent cases for years. The following steps will show diagnose vestibular neuronitis.
Instructions
1. Obtain the presenting symptoms for vestibular neuronitis. The most common complaint is debilitating vertigo accompanied by nausea and vomiting. Patients feel as if the room were spinning, which gets worse with head movement.
2. Check for involuntary eye movements (nystagmus). This is the most important physical finding and is characterized by fast oscillations toward the good ear. It may be apparent only when the patient looks toward the good ear. Patients may use visual fixation to suppress the nystagmus.
3. Perform Hallpike maneuvers. The patient must lie back from a sitting to a prone position three times; once with the head forward, once with the head turned 45 degrees to the right and once with the head turned 45 degrees to the left. A diagnosis of vestibular neuronitis is supported if Hallpike maneuvers induce vertigo.
4. Make differential diagnoses. The vertigo probably has a central origin if the nystagmus is multidirectional. Other possibilities include hearing loss, an inflamed eardrum or cranial nerve deficits.
5. Distinguish between light-headedness and true vertigo. Low blood sugar, anemia and cardiac arrhythmia commonly cause light-headedness. Laboratory studies are rarely helpful in determining the cause of vertigo.
Tags: with head, once with, once with head, Hallpike maneuvers, head turned, head turned degrees