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An -itis Lesson

So, despite what the internet says, not all dizziness and vertigo is caused by BPPV. And, no matter how many Epleys you choose to do (despite me telling you not to), the dizziness is just not going away.

Now what? Well, let’s start at the common diagnoses I see.

Vestibular neuritis. Labyrinthitis.

Both of these conditions signify there is an inflammation within the vestibular system itself, either along vestibular nerve or the labyrinth, respectively.

But, before I continue, I need to go a little bit into the anatomy of the vestibular system.

Vestibular Nerve: starts in the brainstem and migrates its way out the skull and attaches to the vestibular system in the inner ear. It is in fact also running along with the Cochlear Nerve (hence, vestibulocochlear nerve, cranial nerve 8) but it only relays information to the brain about the position of the head and is not involved with hearing.

Peripheral Vestibular System Apparatus-showing vestibular nerve

Vestibular Labyrinth: This is the structure that houses the semicicular canals (where BPPV occurs) and the otoliths. Both are involved with sensing the position of the head and relays what it senses to the brain via the vestibular nerve.

Now that you’ve got the basic of the basics down, let us continue.

As I mentioned before, vestibular neuritis and labrinthytis occur when there is inflammation to the vestibular nerve or the labyrinth. This can occur due to a viral infection either specifically at the region or elsewhere in the body.

When this occurs in either condition, there is usually a very strong sensation of vertigo that lasts a few days. In the case of labyrinthitis, people may also experience tinnitus (ringing in the ears–and I’ve heard it pronounced a couple different ways so don’t worry about saying it incorrectly) or a loss of hearing (usually on just one side). There can also be nausea, vomiting, and a feeling of imbalance/loss of balance.

After a few days, these severe symptoms subside but, then people are usually left with a feeling of dizziness (a sensation that is different than vertigo) and feeling unsteady when they are moving around.

These symptoms can be resolved but, I would, again, recommended physical therapy. It can just be a few simple exercises that take 20 minutes out of your day that help quickly recalibrate your inner ear and help you feel less dizzy. But getting the RIGHT exercises is necessary. And, that’s not going to be an Epley (unless you also have BPPV, which can happen).

So, be not afraid of vestibular neuritis or labrynthitis. While the initial days are going to likely be a harrowing experiencing, YOU DO NOT HAVE TO LIVE YOUR LIFE WITH THESE SYMPTOMS. An experienced PT will get you started on the right path.

Questions? Send me an email, comment, or message on social media. I’ll be happy to respond.


Therapy Tash

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