Vestibular neuronitis: a review of a common cause of vertigo in general practice

Vestibular neuronitis is an interesting condition characterized by the acute onset of vertigo, nausea and vomiting, in the absence of hearing loss or tinnitus. There is often evidence of a recent or concurrent upper respiratory tract infection. The disease follows a benign course of between two days and six weeks. It often occurs in epidemics. Following the acute attack, mild transitory episodes of dizziness may recur over a period of 12 to 18 months. Clinical and histopathological evidence suggests that it is caused by an isolated lesion of the vestibular nerve, although the exact aetiology remains obscure. Vestibular neuronitis is a relatively common condition in general practice, but has lacked clear definition, partly as a result of confusion over its nomenclature. Current knowledge of vestibular neuronitis is reviewed. Clinical diagnostic criteria are described, and the diagnosis and differential diagnosis of the syndrome in general practice are outlined. There remains a need to describe the occurrence of vestibular neuronitis in general practice in greater detail.