vestibular neuronitis
Introduction
Introduction to vestibular neuronitis Vestibular neuron inflammation is a kind of sudden vertigo caused by vestibular neuron involvement, which is a kind of peripheral neuritis. The lesion occurs in the centripetal portion of the vestibular ganglion or vestibular pathway. More than two weeks before the illness, there was a history of upper respiratory tract infection. Dizziness and spontaneous nystagmus are its main clinical manifestations. Severe cases can be accompanied by nausea and vomiting, but no tinnitus, deafness, and vertigo last for a short time. It usually relieves within a few days. Generally, it can be fully recovered within 2 weeks. A small number of patients may have different levels of dizziness, dizziness and instability for a short period of time. It lasts for several days or several months, and the symptoms are aggravated during activities. basic knowledge Probability ratio: the incidence rate is about 0.006% Susceptible people: no specific population Mode of infection: non-infectious Complications: vertigo, brain syncope
Cause
Vestibular neuronal inflammation
Diabetes (5%):
Diabetes can cause degenerative atrophy of vestibular neurons leading to repeated vertigo attacks. Some patients with vestibular nerve severance, pathological examination can be found in the vestibular nerve with or without degenerative changes and regenerative nerve fiber reduction, ganglion cell vacuolization, increased collagen deposition in the nerve.
The vestibular nerve is stimulated (20%):
The vestibular nerve suffers from vascular compression or arachnoid adhesions and even neurogenic dysfunction caused by stenosis of the internal auditory canal.
Virus infection (30%):
Serum levels of herpes simplex and herpes zoster virus were significantly increased after vestibular neuron inflammation.
Immunity factor (5%):
There may be an autoimmune response.
Prevention
Vestibular neuronitis prevention
No contagious, early symptoms like a cold, easily overlooked by patients.
1. Pay attention to enhance physical fitness and prevent upper respiratory tract infections.
2. Early comprehensive treatment to reduce complications.
Complication
Vestibular neuron complication Complications vertigo brain syncope
A small number of patients may have varying degrees of dizziness, dizziness and instability.
Symptom
Vestibular neuron symptoms Symptoms Nausea, hearing loss, hearing loss, tinnitus, vertigo, vestibular nerve damage, palsy, mastoiditis
1. The onset is often sudden, and dizziness and spontaneous nystagmus are the main clinical manifestations.
2. Severe cases may be accompanied by nausea, vomiting, but no tinnitus, deafness; vertigo lasts for a short period of time, often gradually relieve within a few days, usually more than 2 weeks can fully recover; a small number of patients can have different degrees of dizziness in a short period of time , dizziness and instability.
3. Sick side vestibular function test (cold and hot water test, etc.) often shows dysfunction or disappearance, sometimes affecting both sides.
4. Hearing tests are often unaffected.
Examine
Examination of vestibular neuronitis
1. Dizziness should be anemia, hypoglycemia, endocrine disorders and other related tests.
2. Cerebrospinal fluid examination is particularly important for the determination of intracranial infectious diseases.
Suspected acoustic neuroma should be taken in the radiograph, cervical vertigo can be used to treat cervical vertebrae, EEG for the diagnosis of vertigo epilepsy, consider intracranial space-occupying lesions, cerebrovascular disease, etc. can choose to do head CT or MRI.
Brainstem auditory evoked potentials are helpful in assisting the localization of vestibular neuropathy.
Diagnosis
Diagnosis and identification of vestibular neuronitis
diagnosis
According to the history of upper respiratory tract infection, sudden vertigo, spontaneous horizontal nystagmus, vestibular dysfunction, no tinnitus, deafness, etc., often can be diagnosed.
Differential diagnosis
1. Although Meniere's disease has sudden vertigo and spontaneous nystagmus, it is often accompanied by tinnitus, and hearing loss may occur after repeated vertigo attacks. The duration of vertigo is shorter, often relieved within hours to days.
2. Benign positional vertigo is caused by otolith lesions in the inner ear. Short-term sudden vertigo and nystagmus occur only in certain head positions (with a certain incubation period), lasting for a few seconds to tens of seconds; repeating the head position When the vertigo is back, the hearing is unobstructed, and the otolith function check can be abnormal.
Any localized vertigo and nystagmus that cannot be explained by surrounding vestibular lesions should be considered for central lesions. MRI should be recommended for posterior cranial fossa.
