Vestibular Neuritis

Vestibular Neuritis: Causes, Symptoms, And Treatment


Medically reviewed by Misty Seidenburg

Vestibular neuritis is an inner ear disorder that causes sudden and intense dizziness, balance problems, nausea, and vomiting. It’s also one of the leading causes of vertigo. While the acute phase of vestibular neuritis may last a few days, some symptoms can take weeks or months to fully resolve. Physical therapy can improve balance and stability for people dealing with this condition to move with confidence after vestibular neuritis.

What Causes Vestibular Neuritis?

Let’s start with the basics. The vestibular system, nestled within the inner ear, is a sophisticated sensory system that maintains our sense of balance and spatial orientation. Crucial to this system is the vestibular nerve, which relays information from vestibular organs on both sides of the head to the brain, enabling us to move with precision.

If this intricate sensorimotor pathway is disrupted, our sense of balance can be impaired. Vestibular neuritis, in particular, affects the vestibular nerve that connects the inner ear to the brain and is commonly caused by viruses and bacterial infections, including:

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

When invaders are introduced to the body, they trigger an immune process at the vestibular nerve. This reduces blood flow and damages nerve cells, causing intense acute symptoms. Once a few days have passed, the residual nerve damage produces post-acute symptoms.

Symptoms of Vestibular Neuritis

As described above, vestibular neuritis symptoms occur in phases.

Acute Phase Symptoms

  • Sudden onset of vertigo
  • Severe motion sensitivity
  • Imbalance and difficulty walking
  • Difficulty focusing and tracking objects visually
  • Nausea/vomiting

Post-Acute Phase Symptoms

  • Dizziness and lightheadedness
  • Motion sensitivity, especially with quick head movements
  • Imbalance and challenges walking in fast-paced environments
  • Difficulty tracking objects, screens, and rapid visual environments
  • Mild nausea

The intensity and duration of symptoms vary from person to person, based on the extent and severity of nerve damage and other pre-existing conditions that may contribute to dizziness. Always share your concerns with your healthcare provider to ensure a proper diagnosis.

Vestibular Neuritis vs. Labyrinthitis

Vestibular neuritis is often confused with vestibular labyrinthitis, and the two conditions are closely related. They both involve the vestibular system and cause similar, sudden, and abrupt symptoms, with gradual improvement in the weeks and months that follow.

However, unlike vestibular neuritis, which affects the vestibular nerve, labyrinthitis affects the labyrinth, the part of the ear that contains organs that help with hearing and balance. Labyrinthitis can cause ear ringing (tinnitus) and temporary hearing loss, which are not usually associated with vestibular neuritis.

Other Vestibular Disorders That Affect Balance and Orientation

Several other conditions affect the vestibular system, causing symptoms similar to vestibular neuritis.

  • Migraines: Vestibular migraines affect balance and cause the sensation of spinning or falling, even while you are still.
  • Traumatic Brain Injury (TBI): Up to half of people with a TBI experience vestibular impairments resulting in dizziness, vertigo, and loss of balance.
  • Meniere’s Disease: This rare inner ear condition causes tinnitus, hearing loss, and severe vertigo.
  • Benign Paroxysmal Positional Vertigo (BPPV) occurs when the tiny, hairlike crystals in the ear that tell the brain when to accelerate are shifted out of position, disrupting the sense of balance.

There are several other possible causes of dizziness, vertigo, and balance problems, including medications, anxiety and stress, and low blood pressure. Diagnosis is essential to receive proper treatment and prevent serious complications.

Vestibular Neuritis Treatment

Treatment for vestibular neuritis typically involves medication and physical therapy. Your healthcare provider may prescribe several medications to treat the underlying virus or infection and ease nausea, dizziness, and inflammation.

What Is Vestibular Rehabilitation?

Vestibular rehabilitation therapy (VRT) consists of exercises and activities to help patients with vestibular disorders manage their symptoms.

This form of physical therapy specifically addresses balance and stability problems, incorporating safe and gentle movements to help the brain adjust to balance changes. VRT starts with a comprehensive evaluation, which allows the vestibular physical therapist to identify specific limitations and prescribe exercises to increase compensation and gradually reduce symptoms.

Benefits of Vestibular Therapy

Vestibular therapy can help you regain your sense of stability, which may be keeping you from doing all the things you enjoy.

Research shows vestibular rehabilitation therapy helps:

  • Lower the risk of falls
  • Improve balance
  • Reduces dizziness
  • Increases physical activity
  • Positively affects emotional health

One clinical study found that weekly physical therapist-guided interventions for at least six months are recommended to achieve optimal results. However, your treatment plan may differ slightly because VRT is customized to your needs and goals. Many options, including in-person, virtual, and home exercises, can be used during a course of care to work with you and get the best results.

Although it’s best to seek treatment at the early onset of dizziness, vestibular therapy can help you achieve some level of improvement, no matter how long symptoms have been present. Check out these patient testimonials to learn how physical therapy is improving lives, and find a physical therapy clinic near you.



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Medically reviewed by

Misty Seidenburg

Vice President of Clinical Programs

Dr. Misty Seidenburg has been a practicing physical therapist since 2006 after obtaining her Doctor of Physical Therapy Degree from Gannon University. Dr. Seidenburg completed an Orthopedic Residency in 2009 and subsequent Spine Fellowship in 2010 where she discovered a passion for educating clinicians. Since 2019, she has developed and refined several post-professional residency and fellowship programs and currently serves as the Vice President of Clinical Programs for Upstream Rehab Institute. She serves on several APTA committees to help advance the profession, is adjunct faculty at Messiah University, and is also a senior instructor and course developer for the Institute of Advanced Musculoskeletal Treatments with a special interest in exercise integration. Outside of work, she enjoys challenging herself with new adventures and is currently competing as an endurance athlete.

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