Vestibular Inflammation: Causes, Symptoms, and Treatment

Please help?

Two weeks ago, I suddenly felt very dizzy.
When I lay down to rest, I felt like the world was spinning, and then I started to vomit.
These symptoms persisted for a while; every morning when I got out of bed, I couldn't get up.
Changing positions would cause the spinning sensation again, followed by vomiting.
After vomiting, I felt a bit better, but then the dizziness would return, and I would vomit again.
This continued, so I went to see a doctor at the emergency department of Renai Hospital.
They suggested it might be an inner ear issue, and after receiving IV fluids, I felt better and went home.
However, the next morning, the same situation occurred, and it was getting worse.
I went to the emergency department at Chang Gung Memorial Hospital in Taipei, received IV fluids again, and went home.
The next day, I visited the ENT department at Chang Gung for an examination (only questions were asked, no instrumental checks), and they also said it was an inner ear problem, so I went home with medication.
This did not improve, and last night the same symptoms appeared again.
This time, I went to the emergency department at Linkou Chang Gung, and the result was the same: IV fluids.
This time, I consulted both the ENT and neurology departments, but they only asked questions and said there was no problem.
They suggested that medication would help.
However, my condition did not improve; in fact, I felt worse.
I then went to the emergency department at En Chu Kong Hospital in Sanxia, where the doctor immediately ordered a CT scan to check for any brain issues.
A neurologist was consulted and said there was no problem, so it should not be a brain issue.
Then, an ENT doctor was called for an examination, which included hearing and balance tests.
However, during the balance test, I couldn't tolerate it and vomited, so the test was stopped.
The ENT doctor said my ears should be fine and that it was likely a neurological issue.
Finally, I went to Kaohsiung Veterans General Hospital for an outpatient examination, where the doctor immediately recommended hospitalization for further evaluation.
After listening to my issues and conducting examinations, the doctor diagnosed me with vestibular neuritis.
He said that with plenty of rest and medication, I would be fine.
● My symptoms and related questions:
○ What is my occupation? Digital camera repair engineer.
○ Is there any family history? No.
○ Have I been taking any long-term medications? No.
○ Have I had a cold recently? Went hiking? Went to the beach? Flew on a plane? No cold, but I had been to the mountains previously.
○ What is the nature of the dizziness? Spinning, floating, or rocking? Spinning in clockwise and counterclockwise directions; when dizzy, it feels like my head is heavy and my legs are light.
○ Do I lean to one side when walking? Which side? Have I ever fallen suddenly? Leaning to the left.
○ How long do the dizziness episodes last? How often do they occur? During the day or night? The episodes last only about ten seconds but occur continuously for several days.
○ Is the dizziness related to any specific position? Does it worsen or improve with certain positions? Dizziness occurs when turning my head or changing angles.
○ Are there any symptoms of nausea, vomiting, cold sweats, pale or flushed face, shoulder pain, neck stiffness, headache, heavy head, or occipital pain? Nausea, vomiting, cold sweats, shoulder pain, neck stiffness, headache, heavy head.
○ Is there any hearing impairment, tinnitus, a feeling of ear fullness, sensitivity to loud sounds, ear pain, or ear discharge? Tinnitus in the right ear but only for a short time.
○ Is there any numbness in the limbs or around the mouth? Blurred vision or temporary blindness? Difficulty speaking or swallowing? Weakness in both legs and arms...
At night, I see double vision (vertical double vision).
Doctor, what kind of condition might this be, and how should I treat it? Should I see a specialist, or is medication sufficient? Should I consider neurological issues? Please help me with these questions.
Thank you.
My contact number: 0920-199-161
EMAIL: [email protected]
Zeng Zhao-Rong

Zeng, 20~29 year old female. Ask Date: 2001/05/13

Dr. Ye Dawei reply Otolaryngology

I'm sorry, but I need the content you want

Reply Date: 2001/05/13

More Info

Vestibular inflammation, often referred to as vestibular neuritis, is a condition that affects the vestibular system, which is responsible for maintaining balance and spatial orientation. This condition can lead to significant symptoms, including dizziness, vertigo, nausea, and vomiting, as you've experienced. Understanding the causes, symptoms, and treatment options for vestibular inflammation can help manage this distressing condition.

Causes of Vestibular Inflammation
Vestibular inflammation is typically caused by viral infections, which can affect the inner ear and the vestibular nerve. Common viral infections that may lead to vestibular neuritis include:
1. Herpes Simplex Virus: This virus can cause inflammation in various parts of the body, including the vestibular system.

2. Influenza Virus: Seasonal flu can also lead to vestibular symptoms.

3. Other Viral Infections: Other viruses, such as those causing colds or gastrointestinal infections, may also be implicated.

In some cases, vestibular inflammation may occur following a respiratory infection, where the virus spreads to the inner ear. It's important to note that vestibular neuritis is not typically associated with hearing loss, which distinguishes it from other inner ear disorders like labyrinthitis.

Symptoms of Vestibular Inflammation
The symptoms you've described align closely with those of vestibular inflammation. Common symptoms include:
- Severe Dizziness and Vertigo: A sensation of spinning or movement, often exacerbated by changes in head position.

- Nausea and Vomiting: As you've experienced, these symptoms can be quite debilitating.

- Balance Issues: Difficulty maintaining balance, which may lead to falls.

- Nystagmus: Involuntary eye movements that can occur during episodes of vertigo.

- Tinnitus: Ringing or buzzing in the ears, although this is less common in vestibular neuritis compared to other inner ear disorders.

Diagnosis
Diagnosis typically involves a thorough medical history and physical examination. Healthcare providers may perform specific tests to assess balance and eye movements. Imaging studies, such as MRI, may be used to rule out other conditions, particularly if neurological symptoms are present.

Treatment Options
Treatment for vestibular inflammation primarily focuses on symptom relief and may include:
1. Medications:
- Antihistamines (e.g., meclizine): These can help reduce dizziness and nausea.

- Antiemetics (e.g., ondansetron): These can help control nausea and vomiting.

- Corticosteroids: In some cases, corticosteroids may be prescribed to reduce inflammation.

2. Vestibular Rehabilitation Therapy (VRT): This is a specialized form of physical therapy designed to help improve balance and reduce dizziness through specific exercises.

3. Rest: Adequate rest is crucial during the acute phase of vestibular inflammation. Avoiding sudden movements and positions that exacerbate symptoms can be beneficial.

4. Hydration: Staying hydrated is important, especially if nausea and vomiting are present.

When to Seek Further Evaluation
If symptoms persist or worsen despite treatment, or if you experience additional neurological symptoms (such as weakness, numbness, or changes in vision), it is essential to seek further evaluation. This may involve consultations with specialists such as neurologists or otolaryngologists (ear, nose, and throat doctors).

Conclusion
Vestibular inflammation can be a challenging condition, but understanding its causes and symptoms can aid in effective management. It's crucial to follow up with healthcare providers to ensure that you receive appropriate care and to monitor your symptoms closely. If you have ongoing concerns or if your symptoms do not improve, consider seeking a second opinion or further diagnostic testing to rule out other potential issues.

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