Vestibular neuritis

This condition is treated in the Ear, Nose and Throat (ENT) clinic.

Pre-referral work-up

History

All referrals should comply to the referral standards and include:

• Constant vertigo for greater than or equal to 24 hours, often with accompanying nausea, vomiting and unsteady gait
• No hearing loss
• Uni-directional mixed horizontal and torsional nystagmus
• Exclude CNS cause:
  • focal neurological signs
  • ataxia & nystagmus which is out of proportion for the degree of vertigo (i.e. florid abnormal nystagmus with mild ataxia)
  • direction-changing or gaze-evoked nystagmus
  • pure vertical nystagmus (i.e. up-beat or down-beat nystagmus)
  • other concurrent eye movement abnormalities (gaze palsy, skew deviation)

Tests

Audiology report if suspicion of hearing loss.

Interim/GP management

To refer a patient with this condition, please see the ENT clinic page for the full referral process and templates.

If CNS signs present, patients should be urgently referred for neurological consultation or attend an Emergency Department:

• Prednisolone 50mg daily for 5 days, followed by a rapid taper in dose
• Acute symptoms may be managed by vestibular sedatives (e.g. prochlorperazine 5 to 10mg orally 3-4 times daily). The duration of prescribing these sedatives should be limited to no more than a few days to minimize side-effects and encourage recovery

For more information please see the HealthPathways Tasmania website.

Clinic appointments

? Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

? If CNS signs present, patients should be urgently referred for neurological consultation or attend an Emergency Department

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

? If there is no evidence of significant recovery of balance within 2 weeks - Cat 1

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Availability

North

Launceston General Hospital
Level 3 - Specialist Clinics

Phone: 1300 977 694
Fax: 03 6777 5227

North West

Unavailable.
See HealthPathways Tasmania for more information

South

Wellington Clinics
Phone: 03 6166 0000
Fax: 03 6234 9454

To contact the on-call ENT Registrar, phone the switchboard on 03 6166 8308.