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Vestibular neuritis, or vestibular neuronitis, is attributed to inflammation of the vestibular portion of cranial nerve VIII and typically presents vertigo, nausea, and gait imbalance.
Vestibular neuritis (VN) is associated with viral infection and considered to be a benign, self-limiting condition lasting several days, to weeks, to months, with medical treatment usually consisting of antiemetics, antihistamines, and benzodiazepines.
A specialist VN management strategy option is a short course of corticosteroids however, an umbrella review (that is a systematic review of systematic reviews) concluded limited evidence to support their use in the emergency department, a combination of vestibular rehabilitation and steroids has been shown more effective than steroids alone.Surprisingly - VN is considered as one of the most frequent causes of vertigo - epidemiological data is scarce. Recently, Italian researchers found rising incidence of VN alongside increases in reported rates of Bell's palsy a cranial nerve (VII) inflammatory condition.
A 28-year-old woman, in her first trimester of pregnancy, awoke at 3am to 'the whole room spinning - it was happening in my dream but then I woke into it fully, like in the movies but real. My arms were numb. I couldn't sit up let alone walk.' Presenting to ED she was sent home, without treatment and a diagnosis of vestibular neuritis. Consulting me three weeks later she said I 'always feel I'm here but not in my own body, I don't feel present.' Blood pressure, thyroid, and iron studies were all within range.
NB: The crucial rubric Vertigo: SEPARATED; body, as if separated from his (found in Schroyens, 2007
is not found in Vithoulkas Compass (2023).COCCULUS INDICUS has feelings of separation from his body, keynotes of true vertigo, the world seems to spin, and great vertigo in the car, and numbness and paralytic stiffness of parts that have been at rest.
Cocculus indicus 200c 1x daily for two days was prescribed with symptoms decreasing over the ensuing week. A ‘very strong anxiety’ for her three year old child (not mentioned prior) had also dissipated – sick from anxiety over a loved one is listed as a keynote of Cocculus indicus by Morrison (7). Repetition of a single dose was required post air travel four weeks’ later.
Smith T, Rider J, Cen S, Borger J. 2023. Vestibular Neuronitis. StatPearls [Internet]. Treasure Island: StatPearls Publishing. PMID: 31751056.
Oliveira et al., 2023. Corticosteroids for patients with vestibular neuritis: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department. Acad Emerg Med. May;30(5):531-540. PMID: 35975654.
Huang et al., 2023. Efficacy of vestibular rehabilitation in vestibular neuritis: a systematic review and meta-analysis. Am J Phys Med Rehabil. Jun 1. PMID: 37339059.
Mandalà et al., 2023. The incidence of vestibular neuritis in Italy. Front Neurol. May 18;14:1177621. PMID: 37273688.
Schroyens, F. ed. 2007. The Essential Synthesis. Reprint 9.x. Assesse, Homeopathic Book Publishers.
Vithoulkas Compass, 2023. Vithoulkas Compass Homeopathy Software [computer program]. Greece.
Morrison, R. 1993. Desktop Guide to Keynotes and Confirmatory Symptoms. Grass Valley. Hahnemann Clinic Publishing.