Diagnosis
In large part, the process involves ascertaining that the entire situation can be explained by a lesion in one or the other vestibular nerve. It is not possible on clinical examination to be absolutely certain that symptoms are not actually caused by a brainstem or cerebellar stroke, so mistakes are possible. Nevertheless, this happens so rarely that it is not necessary to perform MRI scans or the like very often. Signs of vestibular neuritis include spontaneous nystagmus and unsteadiness. One may notice that vision is disturbed or jumpy on looking to a particular side. This usually means that the opposite ear is affected – it is called Alexander's law and is due to asymmetric gaze evoked nystagmus. Occasionally other ocular disturbances will occur such as vertical double vision – skew deviation. However if symptoms persist beyond one month, reoccur periodically, or evolve with time, testing may be proposed. In this situation, nearly all patients will be asked to undergo an audiogram and an electronystagmography (ENG). An audiogram is a hearing test needed to distinguish between vestibular neuritis and other possible diagnoses such as Ménière's disease and Migraine. The ENG test is essential to document the characteristic reduced responses to motion of one ear. In severe cases, vestibular neuritis can become a chronic health problem that may lead to damage of the vestibular nerve(s) which can subsequently result in complications relating to balance and equilibrium which may persist for months or more. If symptoms do not improve, Vestibular Rehabilitation Therapy (V.R.T.) should be used, which is a form of physical therapy that helps dizziness and balance disorders. It is highly effective in alleviating the oftentimes debilitating attacks of vertigo and constant dizziness suffered by those with vestibular neuritis as well as other inner ear disorders and diseases.
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