Demystifying Dizziness- Vestibular Neuritis
You are a super mom- flying around bringing your kids to their various activities, organizing family events on the weekends, all while keeping a standard 9:00-5:00 job. One evening when you are sitting down with your husband after putting the kids to bed you begin to feel slightly nauseous and over the course of a few minutes you begin to feel slightly uneasy. You go to get up to get some fresh air and BOOM! Everything around you explodes into spinning movement and your husband catches you as you begin to stumble.
Have you ever experienced a similar situation described in the story above? If so, what just happened? This situation describes a classic presentation of vestibular neuritis. Vestibular refers to the balance system in your inner ear, while neuritis refers to nerve inflammation. In short, vestibular neuritis means inflammation of the vestibular (balance) nerve, which communicates with your inner ear and your brain.
As with most conditions that trigger dizziness, vestibular neuritis can be a terrifying thing to experience. Its classic hallmark is its gradual onset of vertigo and imbalance that builds up over the course of minutes to hours in a slow explosion to when symptoms peak. Unlike BPPV in which the episodes of dizziness occur in short bursts that last seconds at a time, vestibular neuritis will trigger a prolonged episode of vertigo that builds up over time and may last days to weeks as symptoms gradually settle.
What causes it?
Vestibular neuritis is most commonly caused by an infection, typically viral in nature. One of the main viruses that is thought to cause vestibular neuritis is the Herpes virus. This is the same virus that causes chicken pox and shingles and it lies dormant in your nerve roots. Normally, this is not a problem, but if this virus becomes reactivated it will trigger nerve irritation and inflammation. If this occurs in a nerve going to your skin it will result in shingles. If this occurs in your vestibular nerve it will result in symptoms of imbalance, vertigo, and nausea.
Vestibular neuritis can affect anyone, though typically it tends to occur more commonly in middle age adults. It is unknown what may trigger it, but some factors may include stress or preceding colds or infections.
Classic symptoms of vestibular neuritis include:
· Sudden onset of vertigo or dizziness
· Imbalance/difficulty walking
· Nausea and vomiting
*Note: vestibular neuritis will not affect your hearing. This is a key differentiating factor of vestibular neuritis from other inner ear problems.
So, you think you have vestibular neuritis…now what?
Early intervention is key! As with any condition, the faster you can seek treatment, typically the better your recovery. This is particularly important with vestibular neuritis.
Think of your brain as a computer. It is constantly getting updates from all of your senses and upgrading its systems based on that information. In the case of vestibular neuritis, the nerve connecting your balance system with your brain has become inflamed and is no longer communicating accurate information about your balance system to your brain. Your brain will take this inaccurate information and try to adapt its systems to fit it. Though, if left alone, vestibular neuritis will gradually resolve on its own, without timely appropriate treatment you will likely experience prolonged problems with imbalance due to the changes in your brain’s programming.
In the early stages of vestibular neuritis, sensations of nausea and vomiting can be quite intense. It is very important to stay hydrated to avoid complicating the situation. In addition, working with a vestibular physical therapist will help to rehabilitate your vestibular system and prevent poor compensation of your brain’s systems. For this same reason, it is equally important to begin moving as soon as possible once acute symptoms begin to settle.
As you progress in your recovery introducing balance exercises will help to strengthen and support your stability. Classes focusing on core stability and coordination, such as Tai Chi, Qigong, yoga, Pilates, and Essentrics are all great ways to support your recovery and help you feel stronger and more balanced!
Dr. Speranza is an upper cervical Chiropractor in Calgary, Alberta, Canada. She follows the protocols of the National Upper Cervical Chiropractic Association (NUCCA) to help people experiencing problems with postural related dizziness regain balance, return to doing the activities that they love, and ultimately take back control of their health.