VESTIBULAR (VIRAL) NEURONITIS
A FAIRLY COMMON ENTITY—-MUST DIFFERENTIAT FROM A VASCULAR ETIOLOGY
ONLY ABOUT 30% FOLLOW OR ARE ASSOC WITH AN URTI!
TERMED VIRAL NEURONITIS IF NO COCHLEAR COMPONENT (JUST VERTIGO)
TERMED NEUROLABYRINTHITIS IF + COCHLEAR COMPONENT
TERMED COCHLEAR NEURONITIS (VIRAL SPIRAL GANGLIONITIS) IF NO VESTIBULAR COMPONENT (COMMONLY MUMPS)
USUALLY A RATHER SUDDEN ONSET—-VERY SYMPTOMATIC (N/V)—NYSTAGMUS IS USUALLY AND HORIZONTAL/TORSIONAL–AND CAN BE VISUALLY SUPPRESSED TO SOME EXTENT
SYMPTOMS USUALLY PEAK IN LESS THAN A DAY OR SO —-ALTHOUGH COMPLETE VESTIBULAR REHAB OFTEN TAKES MONTHS (USUALLY PERSISTENT MOTION INTOLERANCEA)—-NOT UNCOMMON TO INSIGHT BPPV
Dx: CLINICAL AND OF EXCLUSION—–ALWAYS CONSIDER CVDz AS INF CEREBELAR ISCHEMIA CAN PRESENT EXACTLY LIKE THIS
Rx: INITIALLY SYMPTOMATIC (COMPAZINE AND VALIUM)—CHRONIC SYMPTOMOLOGY ARE BEST TREATED BY REHAB AND COMPENSATION