Dr Nick Dunn: You make my head spin

As GPs we frequently see people who are experiencing sudden onset of dizziness, often associated with nausea or even vomiting. This can be so severe that at times people are unable to stand or leave their beds although most people make it into the surgery. It can be very alarming and although serious conditions such as stroke and brain tumours need to be ruled out through clinical examination, most commonly the problem is due to a problem called vestibular neuritis.

Vestibular neuritis is a medical condition that affects the inner ear, specifically the vestibular nerve, which is responsible for helping us maintain balance. Though the name might sound complicated, it’s important to know that vestibular neuritis is relatively common, can cause noticeable symptoms, and is treatable.

The vestibular nerve plays a crucial role in sending signals from the inner ear to the brain to help us sense balance and orientation. When the vestibular nerve becomes inflamed, it disrupts the brain’s ability to receive accurate balance signals, which can lead to dizziness and other symptoms.

Vestibular neuritis can affect anyone, but it is most common in adults between the ages of 30 and 60. While the condition can affect both men and women, it tends to be slightly more common in women. In terms of how many people it affects, studies suggest that vestibular neuritis is responsible for around 10-15% of all cases of dizziness and balance disorders, making it one of the more common causes of vertigo.

The main symptom of vestibular neuritis is sudden, severe vertigo (the feeling that you or the room is spinning). This dizziness can begin suddenly and may last anywhere from a few hours to several days. Other common symptoms include:

l Nausea and vomiting due to dizziness

l Difficulty with balance and walking

l A sense of unsteadiness, especially when moving the head

l No hearing loss (unlike another condition called labyrinthitis, which can also cause ear problems)

It’s important to note that vestibular neuritis doesn’t cause hearing loss or ringing in the ears (tinnitus), which distinguishes it from some other ear-related conditions.

The good news is that vestibular neuritis is treatable. The treatment focuses on relieving symptoms and helping the body recover its balance function. Some of the most common treatments include:

l Medications: These might include anti-sickness drugs or vestibular suppressants.

l Vestibular rehabilitation therapy (VRT): This is a type of physical therapy designed to help patients retrain their balance system.

l Rest and time: In many cases, the inflammation will gradually heal on its own, and symptoms will improve as the vestibular nerve recovers. Most people start feeling better within a few days, though complete recovery can take weeks.

Feeling dizzy can be a very unpleasant and disorientating problem, but it is important to be seen by your GP to rule out serious underlying causes such as low blood pressure, anaemia or significant brain problems, in addition to getting some effective treatment. It’s all about restoring your balance.