Vestibular Neuritis: Manifestations and Therapeutic Approaches
Acute vestibular neuritis is a condition that affects the vestibular nerve, causing symptoms such as vertigo, nausea, balance issues, vomiting, difficulty seeing, and difficulty concentrating. This article provides an overview of common treatments for managing this condition.
Treatment for acute vestibular neuritis typically focuses on medications, vestibular rehabilitation exercises, and lifestyle/dietary considerations.
### Medications
Corticosteroids, such as prednisolone, are strongly recommended as they significantly improve vestibular function and speed recovery. A common regimen is prednisolone 1 mg/kg daily for 5 days followed by a taper over 15 days. Antiemetics, such as prochlorperazine, ondansetron, granisetron, and promethazine, may be used to control nausea and vomiting during acute episodes. Benzodiazepines like diazepam can be used in severe cases to relieve vertigo symptoms but are generally used cautiously due to side effects and sedation.
However, antiviral therapy like valacyclovir is not shown to be beneficial in vestibular neuritis and thus not recommended.
### Vestibular Rehabilitation Exercises
Early initiation of vestibular rehabilitation therapy (VRT), which involves balance and walking exercises, is advised as it helps patients regain balance and recover faster by retraining the brain to compensate for vestibular loss. These exercises aim to promote central compensation and are preferred over prolonged medication use, which can delay recovery if used excessively.
### Diet and Lifestyle Tips
While direct dietary modifications for vestibular neuritis specifically are less documented, some general vestibular disorder advice may apply. Maintaining adequate hydration is beneficial. Avoiding triggers such as excessive caffeine, alcohol, and tobacco can help reduce symptoms or prevent exacerbations. Unlike Meniere's disease where a low-sodium diet is recommended, no specific sodium restriction is typically emphasized for vestibular neuritis.
In conclusion, acute vestibular neuritis management centers on corticosteroid therapy, symptomatic control with antiemetics, and early vestibular rehab exercises, complemented by general lifestyle adjustments to mitigate symptoms and support recovery. It is crucial to seek medical attention for symptoms of vestibular neuritis, especially if a person is unable to keep liquids down, as prolonged vomiting can lead to dehydration.
Once feeling well enough, eating bland foods like toast or soup with crackers is recommended. Foods and drinks containing high levels of salt or sugar, nicotine, alcohol, dairy, and caffeine should be avoided.
It is important to note that vestibular neuritis symptoms typically last for several days, though they may take weeks or months to completely resolve. If symptoms persist or worsen, or if new symptoms such as slurred speech, problems with vision, numbness or tingling, weakness on one side of the body, arise, emergency services should be contacted immediately, as these could be signs of a stroke.
Labyrinthitis, which is inflammation of the labyrinth, a part of the inner ear that helps control hearing and balance, is different from vestibular neuritis and can cause hearing loss.
During the acute stage of vestibular neuritis, a doctor may prescribe medications such as antihistamines, antiemetics, and benzodiazepines to help suppress nausea and dizziness. Other strategies to help minimize or relieve vestibular neuritis symptoms include standing with feet close together and slowly rocking back and forth, and doing diet tips like avoiding caffeine, alcohol, and spicy foods.
Home care, dietary changes, and medications can help manage symptoms and treat any underlying viral or bacterial infection. However, it is crucial to take these medications for a limited time, as continued use can prevent the brain from compensating for the vertigo, leading to ongoing vertigo.
- The use of corticosteroids like prednisolone, along with a taper over 15 days, is strongly recommended for acute vestibular neuritis, as they significantly improve vestibular function and speed recovery.
- Antiemetics, such as prochlorperazine, ondansetron, granisetron, and promethazine, may be used to control nausea and vomiting during acute episodes of vestibular neuritis.
- Vestibular rehabilitation therapy (VRT), which includes balance and walking exercises, is advised as it helps patients regain balance and recover faster by retraining the brain to compensate for vestibular loss.
- In the management of acute vestibular neuritis, antihistamines, antiemetics, and benzodiazepines might be prescribed by a doctor to help suppress nausea and dizziness.
- Diet tips like avoiding caffeine, alcohol, and spicy foods could be strategies to help minimize or relieve symptoms of vestibular neuritis, alongside home care and medications.
