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Acute Vestibular Syndrome due to Vestibular neuritis and Stroke
Acute vestibular syndrome presents with an abrupt onset of vertigo (spinning sensation), which is worse when the head is moved but it is present even at rest. Nausea, vomiting and lack of balance are typical. Some patients may have only mild symptoms while others look pale and sick. Horizontal nystagmus with fast phase to the healthy side is universal.
Vestibular neuritis is a disease of the vestibular nerve, carrying information, from the labyrinth to the brain. Vestibular neuritis is believed to be caused by viral infection similar to Bell ’s palsy.
Vertigo and nausea usually last from days to a couple of weeks and are rapidly improving. Complaints of some dizzy sensation may last for months following the recovery. Vestibular neuritis is unlikely to reoccur.
Treatment is directed to the symptomatic relief of symptoms of vertigo and nausea.
Acute Vestibular Syndrome in Stroke
Occasionally, stroke may present with similar symptoms of an acute vestibular syndrome. Isolated vertigo as a single symptom of a stroke is very unlikely. Neurological examination should reveal other symptoms of abnormal eye movements, coordination deficits, loss of sensation, tremor, or weakness.