vestibular function after an episode of vertigo may take several weeks. Diagnosis is carried out by methods of lamisil pill the vestibular analyzer, according to buy terbinafine, MRI is performed. The basis of treatment is the appointment of vestibular suppressors in the first days and the subsequent use of vestibular gymnastics. The prognosis is favorable. Causes of vestibular neuronitis Symptoms of vestibular neuronitis Diagnosis Differential diagnosis Treatment and prognosis of vestibular neuronitis Prices for treatment. Causes of vestibular neuronitis.
The etiofactors of vestibular neuronitis are not entirely clear. The substrate of the disease is considered to be an inflammatory process that selectively affects the vestibular nerve. Most likely, the inflammation has a viral etiology. This is confirmed by the manifestation of neuronitis after acute respiratory viral infections. There are cases when herpetic encephalitis developed against the background of vestibular neuronitis, and therefore it is assumed that one of the etiofactors is the herpes simplex virus. In favor of infectious etiology, the described cases of terbinafine cheap of several family members at once testify.
Vestibular neuronitis is a selective lesion of the vestibular nerve, presumably of inflammatory origin and manifested by a single acute paroxysm of intenseo dizziness with balance disorder and complete hearing loss. Compensation of A number of authors speak in favor of an infectious-allergic mechanism for the development of vestibular neuronitis, in which viruses are sensitizers and provoke a local autoimmune inflammatory process. Inflammation, as a rule, affects the upper branch of the vestibular nerve. Pathology of the lower branch is noted much less frequently. The auditory nerve remains completely intact. In addition, cases of vestibular neuronitis of toxic origin, caused by the use of antibiotics of the aminoglycoside series, in particular gentamicin, are described.
Vestibular neuronitis is not accompanied by a recurrence of paroxysms of dizziness. Recurrence is observed only in 2% of cases and affects only the previously healthy side. If a patient diagnosed with vestibular neuronitis has new episodes of acute intense vertigo, doctors should reassess the diagnosis.
The neurological status shows spontaneous nystagmus with a rapid phase away from the affected ear. It persists for 3-5 days after the end of terbinafine pills. Even within 2 weeks, nystagmus is detected, which occurs when looking away towards the healthy side. In the Romberg position, the patient deviates to the affected side.
The diagnosis can be confirmed by the detection of unilateral vestibular areflexia or hyporeflexia when performing indirect otolithometry (caloric test). If the results of the latter are negative, a study of vestibular EPs (evoked potentials) is carried out, since the pathology of the lower branch of the nerve does not lead to changes in the results of indirect otolithometry. In difficult cases, MRI of the brain makes it possible to exclude intracranial pathology and reveal indirect signs of neuronitis.
In addition to an examination by a neurologist or otoneurologist, to clarify the diagnosis, a consultation with a vestibulologist is recommended with vestibulometry, electronystagmography and other studies of the vestibular analyzer. It is most difficult to differentiate vestibular neuronitis from a first episode of Meniere's disease. The combination of dizziness with tinnitus, hearing loss and a feeling of lamisil inside the ear testifies in favor of the latter. A feature of migraine is the presence of a headache uncharacteristic of neuronitis.
The vertebral artery syndrome occurs with repeated episodes of dizziness of shorter duration, usually occurs against the background of pathology of the cervical spine (osteochondrosis, cervical spondylosis, Kimerli's anomaly). Treatment and prognosis of vestibular neuronitis. Drug therapy is symptomatic and is aimed at stopping dizziness and vestibular dysfunction. The main drugs are vestibulosuppressors: dimenhydrinate, metoclopramide, phenothiazines (fluorophenazine, thiethylperazine, thioridazine, promazine), benzodiazepine tranquilizers (nozepam, diazepam, gidazepam).
The duration of their use is dictated by the severity of dizziness. Usually it is limited to 3 days, since these drugs inhibit vestibular compensation. Clinical studies have shown a higher percentagecomplete vestibular recovery in patients who took methylprednisolone at a dose of lamisil 250 mg in parallel with the main treatment for the first 3 days, followed by a decrease in dosage by 20 mg every 3 days. The use of antiviral drugs, in particular antiherpetic drugs) did not show a significant increase in the effectiveness of therapy.
A number of clinicians suggest the use of betahistine as a drug that accelerates vestibular compensation. . Vestibular gymnastics aims to achieve vestibular compensation as soon as possible. It is recommended from the 3-5th day of illness, when the patient completely passes vomiting. Until this period, the patient should observe bed rest with immobilization of the head. The first exercises of vestibular gymnastics are turns in bed and sitting down.
When the patient succeeds in suppressing nystagmus by fixing the gaze, exercises with fixation of the gaze from different angles of vision, smooth eye movements, horizontal and vertical movements of the head with a fixed gaze are introduced. During this period, the patient is gradually allowed to stand and walk. As training exercises, walking with closed eyes is used with support from the side. On the 5th-7th day, provided that there is no nystagmus with a direct look, exercises are introduced to train static and dynamic balance.
After a neuronitis, complete recovery of vestibular function is noted in about 40% of those who have been ill, and incomplete recovery in 30%. In the rest of the patients persistent vestibular areflexia persists. Vestibular neuronitis: causes, symptoms, principles of diagnosis and treatment. The source of the disease, presumably, is a selective inflammatory process of the vestibular nerve (8th pair of cranial nerves). Selective, because other nerve fibers of the body remain intact, which remains not completely clear today. What causes inflammation of the vestibular nerve?