Labrynthitis And Vestibular Neuronitis

Etiology

  • Viral inflammatory process
  • If vertigo and sensorineural hearing loss, referred to as labrynthitis (i.e. involving both vestibular and cochlear branches of CN8)
  • If only vertigo, referred to as vestibular neuronitis (i.e. involving only vestibular branch of CN8)

Symptoms

  • Often URI sx prior, then abrupt onset vertigo
  • Acute N, V, and gait problems that can be disabling
  • Self limited → lasts a few days
  • Also some unilateral hearing (sensorineural) loss w/labrynthitis

Physical Exam Findings

  • External canal and TM should be normal (assuming no co-existing conductive loss)
  • Severe dizziness w/any movement, unstable gait
  • With labrynthitis: also SN hearing loss; If patient hums, sounds louder in normal ear; Weber w/512hz tuning fork lateralizes to normal ear, Rinne indicates air conduction better than bone