Vestibular Neuritis VS BPPV 2021

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Vestibular Neuritis VS BPPV is both inner ear disorders that cause dizziness, nausea, vomiting, motion sickness, headaches, & occasional hearing issues. They both are also known for causing vertigo-like symptoms in patients. While both of these conditions can present with almost similar symptoms on the surface, they are different & the differences are quite crucial for their treatment.

Vestibular Neuritis arises out of an infection or inflammation in the vestibular nerve of the inner ear, which is responsible for carrying balance-related signals from the inner ear to the brain. When this nerve gets inflamed or swollen due to an infection, either bacterial or viral, it can’t function properly & the transfer of balance-related signals from the inner ear to the brain gets hampered.

This causes symptoms like dizziness, nausea, lightheadedness, disorientation, loss of balance, inability to walk straight, headaches, & other vertigo-like symptoms. patients also feel ear discomfort, earache, & fever along with other vertigo-like symptoms.

Since Vestibular Neuritis is caused by an infection, the vertigo-like symptoms also usually resolve after the resolution of the initial infection.  In some cases, however, the vertigo-like symptoms may persist even after the initial infection goes away.  Below, we’ll learn in greater detail about both of these balance disorders.

Vestibular Neuritis VS BPPVVestibular Neuritis:

Vestibular Neuritis is an inner ear disorder caused by a bacterial or viral infection of the vestibular nerve.

The inner ear houses the body’s vestibular system, which helps maintain the body’s balance & position in space by sending appropriate balance & position-related signals to the brain.

The vestibular nerve is an important part of the vestibular system, as it is responsible for sending balance-related signals to the brain & carry signals from the brain to the inner ear.

When this nerve gets inflamed due to an infection, it can’t send adequate balance-related signals to the brain, which leads to dizziness, lightheadedness, disorientation, wooziness, nausea, vomiting, headache, & other vertigo-like symptoms.

Patients with Vestibular Neuritis often also experience earache & fever, along with all the other vertigo-like symptoms.

The condition itself may take up to three weeks to resolve on its own. In some cases, patients might have to take medicines like antibiotics, anti-dizziness, & anti-nausea medications to get relief from their symptoms.

The resulting vertigo-like symptoms, including dizziness, nausea, & headaches, might last longer, for about three months after the initial infection resolves.

Vestibular Neuritis symptoms:

Vestibular Neuritis symptoms usually come on quite quickly & are often the most intense when they appear at first.

Some of the most common vestibular neuritises symptoms include:

  • Sudden vertigo attacks
  • Balance problems
  • Nausea & vomiting
  • Dizziness
  • Trouble with concentration & focus

Hearing issues are not normally a symptom of vestibular neuritis.

Vestibular Neuritis causes:

Viral infections, either in the inner ear or other parts of your body, are the most common cause of vestibular neuritis.

Some common viral illnesses that can cause Vestibular to include:

  • Measles
  • Flu
  • Rubella
  • Mononucleosis
  • Mumps
  • Chickenpox
  • Shingles

In some cases, bacterial infections can also cause Vestibular Neuritis. Although it is not very common.

Vestibular Neuritis diagnosis:

Before they can make a Vestibular diagnosis, your doctor will likely rule out any other potentially serious causes of dizziness & vertigo-like symptoms. These include stroke, brain tumors, Multiple Sclerosis, & any other auto-immune conditions or deformities.

They will make a diagnosis based on a hearing test which will narrow down which of your nerves is affected. If the vestibular nerve turns out to be the affected one, your doctor will diagnose your condition as vestibular neuritis.

Vestibular Neuritis treatment:

Vestibular Neuritises treatment generally consists of antibiotics or antiviral medications to treat the underlying infection or illness. No standard treatment protocol exists for Vestibular Neuritis, but treatment focuses on relieving the individual symptoms of the condition.

Your doctor will likely prescribe you some medication to treat dizziness & nausea that occur along with Vestibular Neuritis. These medications include:

  • diphenhydramine (Bendadryl)
  • meclizine (Antivert)
  • lorazepam (Ativan)
  • diazepam (Valium)

If your symptoms show no signs of improvement even after a few weeks & medications, then vestibular rehabilitation therapy might be a viable option for you. This includes some specific exercises that help train your brain to compensate for the vestibular system by employing other organ systems in its place.

BPPV(Benign Paroxysmal Positional vertigo)

BPPV is another inner ear disorder, also known as the most common cause of vertigo & dizziness among adults. BPPV is caused by the displacement of tiny calcium crystals that normally rest in the middle ear, into the semicircular canal of the inner ear. There they cause problems with the way the inner ear sends signals to the brain about the body’s balance, & lead to symptoms like dizziness, lightheadedness, nausea, disorientation, & other vertigo-like symptoms.

BPPV accounts for about 80% of all vertigo cases among adults.

BPPV symptoms:

BPPV symptoms might differ from one person to another, although there are a few symptoms that are common across all patients.
These include:

  • Dizziness that comes on suddenly
  • A spinning sensation, as if your surroundings are moving around
  • Loss of balance or unsteadiness
  • Nausea
  • Vomiting
  • nystagmus(abnormal, rhythmic movements of the eye)

BPPV signs & symptoms usually come & go in intervals, & each episode normally lasts for about a minute. It’s also possible for BPPV episodes to completely disappear for some time, only to reappear later on. BPPV attacks are usually also triggered by changes in the position of the head, any sudden head movements, & performing activities like standing or walking. Age is usually a factor for BPPV, so is any head injury, neck injury, or blunt force trauma to the head. In some cases, it’s possible that BPPV has no known cause at all. When this happens, it’s usually because of a past injury that is only now causing symptoms.


BPPV diagnosis:

Nystagmus(an abnormal, rhythmic eye movement) is usually your doctor’s cue to diagnose BPPV.  Your doctor will be doubly sure that you’re suffering from BPPV if the eye movements occur along with dizziness after you change the position of your head or perform any sudden head movements. In addition, your doctor may utilize some tests to reach the most accurate diagnosis. These tests include:

  • ENG(electronystagmography test): This test uses electrodes placed on either side of your face to record any abnormal eye movements, as the doctor moves your head in different directions. The presence of eye movements(nystagmus) signifies BPPV.
  • VNG(videonystagmography test): This test is a modified version of the ENG test. It uses tiny cameras placed above your eyes to record any abnormal eye movements during the test.
  • MRI: Your doctor may also order an MRI if they feel that some other, potentially dangerous condition is causing your dizziness & other vertigo-like symptoms.

BPPV treatment:

BPPV treatment usually involves a combination of vertigo medicines, vertigo exercises(also known as canalith repositioning maneuvers), & certain home remedies.

Vertigo medicines that are helpful in BPPV treatment include:

  • Meclizine tablet
  • Vertin tablet
  • Stugeron-forte tablet
  • Stemetil MD tablet
  • Antihistamines
  • Anticholinergics
  • Anti-nausea medicines
  • Dizziness medicines
  • Motion sickness medicines
  • Anti-anxiety medications
  • Antidepressants
  • Vitamin supplements
  • Herbal supplements like Ginkgo Biloba
  • Getting adequate rest & 8 hours of sleep every night
  • Eating a rich, healthy diet consisting of vitamins, minerals, & green leafy vegetables

Vertigo exercises that are recommended for BPPV treatment include:

  • The Epley Maneuver
  • The Brandt-Daroff exercises
  • The Semont-Foster maneuver
  • The half-somersault maneuver

In some cases, surgical alternatives might be necessary, especially if a patient’s condition is unresponsive to any of the above-mentioned treatments available.

It’s also possible, in some cases, for BPPV to go away on its own without any medical treatments.

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