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Vestibular Neuritis
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Vestibular Neuritis

Hello,

2 weeks back, I have been diagnosed with Vestibular Neuritis in my right ear, due to a systemic viral infection. The MRI shows no acoustic neuroma.

Dr prescribed prednisolone and anti-viral for 1st week.

Can you pls tell me how long will it take to cure? My ENT says it takes 6 weeks to completely recover.

Will symptoms go away completely? The reduction in vestibular function in my right ear will return or balance will recover because of compensation?

I would be greatful if you can share your comment.

Thanks

Rajib
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Avatar_n_tn
The popular theory is that one of the Herpes viruses is responsible for this type of issue. Not necessarily the sexually transmitted Herpes. Any how, as you know, technically there is no cure for herpes. The anti viral meds will supress the virus, and hopefully if all goes as planned, the symptoms will go away.

Timre required for the symptoms to supress....  I am not sure on that one. Ask your treating MD.

Even if one side of your vistibular system was "killed" so to speak....  you eventually would be able to control your balance.

The balance system is extremely complex, but in a nut shell, the body has a lot of "back up systems." Your eyes, touch, feet, sensors within your muscles, all play a role in the balance system.  When one goes weak, the other takes over.  For example, blind people still walk.

Good luck, and I think you will be fine.
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Avatar_n_tn
Hello
I am  a 32 year old Indian woman who lives in London. I had the flu the last week of August and have been very unsteady since the first week of September. I had an MRI taken which was clear and my balance is terrible. I am not able to walk and I have floaters in my eyes. I have been sent to a balance specialist who says it will take a while for it to be repaired. While the neurologist called it BPPV, the balance specialist says its vestibular neuritis. What is it I have? and when will I be able to walk again? I have been asked to do exercises..but it seems unlikely that I will get well with no medicines. Please help me.
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Avatar_n_tn
You are right, they are not the same. To diagnose BPPV a simple procedure called the Dix Hallpike needs to be done. It is non invasive & painless.

VN, well that is kind of a punt. Espeacially if there has not been any tests like ENG etc.  Even then ENGs are not very accurate....  50% of all those with normal ENGs do have some type of pathology that is not found through ENG studies. That said, it is still widley used and accepted as the standard of care.

Prognosis for you....  I can not really say because I do not know what is wrong with you. I would guess that the answer is Yes, eventually things will get better.
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152264_tn?1280358257
If you've seen a balance specialist and been given exercises for vestibular rehabilitation therapy, follow through with those exercises! They are the best way to achieve compensation for the injury to your vestibular system.

Medications can help with symptoms, but they can also impair long-term compensation, which is your goal. In other words, vestibular-suppressant medications can be working against you in the long term. Most people DO recover fully from vestibular problems over time. If it's only been a month, it's way too early to give up hope. Some people recover in weeks, others may take several months.

Are you working with a physical therapist (I think they are called physiotherapists on your side of the "pond") who specializes in vestibular rehab?

An excellent site for education about issues of dizziness is Dr. Hain's site at www.dizziness-and-balance.com.

Hang in there with the exercises, and try to stay active with a sport, walking, or whatever you like to do. The brain can't compensate if it's not getting input through movement. Challenge yourself, though without making yourself miserable. Your therapist should help you find the right level of activity.

Best wishes & good luck.

Nancy T.
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Avatar_n_tn
I'm hearing all these hopeful responses to those with VN and I have to say you are all "full of it."

I was diagnosed originally with BPPV. I had a CAT scan and MRI done on me at the hospital to rule out a stroke initially as the symptoms of vertigo and stroke are often the same and only these tests can determine what is causing the symptoms of dizziness, nausea, vomiting, nystagmus etc.

The Doctors in the emergency room then recommended me into the care of a Neurologist. Why a Neurologist I don't know. For you laymen out there Neurology is for people with brain damage from strokes. They already ruled out stroke at the emergency room in the hospital so why they sent me to a Neurologist, I still don't know. Maybe it was because I've got really good Medical Insurance and this Neurologist was a friend hurting for patients...the three times I saw him I was the only one in the waiting room.

Now about 6 weeks have passed and I still have not really even been oficially diagnosed yet. And this Neurologist wanted me to come back and see him in a couple of weeks again for what... I don't know. The Antivert he prescribed and the Bayer aspirin sure wasn't helping restore my health.

Finally after making some inquiries of my own to the Medical Field, I found out I should be seeing an ENT Doctor. In fact more specifically an ENT specialist called an Otolaryngologist who specializes exclusively in balance disorders of the inner ear.

I saw this Doctor 3 times and he did the ENG test and after a sum total of maybe five minutes total face time with this Specialist, he offers I have Vestibular Neuritis probably caused by a viral infection. He prescribed the obligatory lists of drugs for me over the next several weeks that might mask your dizzy symptoms at best, but do nothing to address the core cause of your VN. After I told him his drugs weren't working and I was just as bad as when I first came down with the vertigo, he got a little upset and short with me and actually told me there was nothing he could do for me and sent me to a physical therapist for VRT (vestibular reflex therapy). There I was given a number of exercises to help my brain "compensate" for the damaged left side of my vestibular system.

I performed these exercises religiously usually three times a day and five different exercises per session. (I was a good patient following Doctors orders and recommendations throughout). I did these exercises for 10 months after which I abandoned them because my symptoms were still just as bad as when I left the emergency room the evening of December 16, 2006.

If you detect a little anger...maybe a little cynicism in my text here, its because I think my treatment for this condition was absolutely abysmal. It showed neglect and maybe incompetence on all levels from the Doctors in charge of my treatment.

It wasn't until several months later from scouring the Internet for information about VN and cures for it out there that I see Prednisone is showing promising results for VN sufferers. Not one of my Doctors mentioned prednisone to me. Of course nearly 3 months passed before I was in to see an Otolaryngologist, who I should have seen the very next day once a stroke was ruled out.

I immediately went looking for PI Attorney specializing in medical malpractice and neglect. Here's another sad note VN sufferers...if you feel your medical care was botched or misdiagnosed like mine, you'll be hard pressed to find an Attorney willing to take your case as there is not much precedent for this kind of law suit and the PI Attorneys like to see a track record of success in a certain area to assess whether they think they can win or not.

Well that's enough, I am coming up on 2 years in December with absolutely no lessening of my symptoms of dizziness, imbalance, fatigue and loss of energy (I dont even notice the nausea anymore...I think I'm immune to it.)

To end this on a bright note, I have gotten use to the constant state of imbalance and dizziness with any and every move I make...maybe this is what the medical community refers to as "compensation". Well let me tell you if this is how its going to be for the rest of my life...getting use to being dizzy, fatigued and out of balance, I dont call that "compensation" I call that "tolerance". I've built up a tolerance to my VN.

How 'bout you out there VN sufferers...any body else see it like I do...or are you all getting better after a few weeks?!
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Avatar_m_tn
I had VN in 2004 for the first time.  I literally thought I was dying...the vertigo was unbelievable.  The vertigo lasted about a week, in which I spent the entire time face down on my bed with my eyes closed.  I went to a doctor who didn't know what was going on.  My uncle, a neurologist, was able to diagnose me over the phone with VN.  Said I just had to wait it out and it could take a while.  After that, I was able to walk, but unbalanced.  I spent the next couple weeks leaning to my left when I walked.  Eventually, everything went back to normal.  

Just last week, I felt it creep up for a good 30 seconds.  The next day, another 30 seconds.  Finally, on april 25th, 2012, it came back hard.  I spent the night vomiting with terrible vertigo (a good 5-6 hours).  By the next morning the consistent vertigo was gone, but the dizziness and nauea were still there.  Today, May 2nd, I feel much better as far as the dizziness goes, but just experienced something for the first time...my left ear has become pressurized, like I'm in a plane that's taking off.  It's very strange and slightly nauseating.  Anyone have anything like that??
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Avatar_m_tn
After reading your letter I thought maybe I wrote it instead of you.  My condition is a mirror image of yours only I've suffered with it for over 7 years now.  My main gripe is the fatigue factor after a lot of physical movement thru the day and my only therapy is just to lay down and be still.  Drugs don't work.  You can qualify for a permanent disability placard so you don't have to walk too far in parking lots.  I've learned to tolerate it as you do but there are times when I just don't have the motivation to even get out of bed.  What the virus has damaged has no cure.  I've accepted that and just move on.  The only answer is surgery to cut the vestibular nerves of the damaged  area to prevent the false signals conflicting with the good signals from your right side. But that also makes you deaf in that ear.   I am a musician so I need all my hearing.  Another therapy I initiated myself was purchasing a recumbent tricycle.  No balace required with 3 wheels and no up and down motion.  Just a nice bucket seat and legs out front pedaling.  I just did a 26 mile marathon with it and felt great afterwards.  Any other exercise that involves movement of my head is totally out of the picture.  Sit down biking is a great alternative.  Give it a try.
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Avatar_m_tn
I have been battling the same thing for fifteen years. I am slightly dizzy all the time. But, occasionally it gets really bad and will last for a week to ten days. Most of the time I can't even get up out of bed. All I can do is lay still in a dark room til it goes away. Lost two jobs as a result of this.  Terrible.
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