Peripheral vestibular disorders with acute onset of vertigo

Disorders of the vestibular nerve and end organs are the most common causes of vertigo. The advances in recognizing different forms of canalolithiasis and cupulolithiasis, which sometimes present with continuous positional nystagmus, have revealed a peripheral vestibular aetiology in which central nervous system lesions were previously suspected. Treatments using repositioning manoeuvres are also successful in cases in which nystagmus does not appear, and when administered by less specialized physicians. In acute vestibulopathy, suspicions of the activation of herpes virus infections as a causative agent are increasing, but no reports on the treatment of such infections are yet available. New treatments are in development for use in Ménière's disease.