What is Vestibular Neuritis?

Vestibular Neuritis

Understanding sudden severe vertigo and what happens next

Last Hearing Aid UK Update: 12/01/2026

Overview

Vestibular neuritis is one of those conditions you've probably never heard of until it happens to you, and when it does, it's genuinely frightening for the person involved. You might wake up one morning, try to get out of bed, and suddenly the entire room is spinning violently.

You might not be able to stand without feeling like you're going to fall over, feeling desperately sick, and any movement makes everything worse.

It's the sort of experience that sends people to A&E, which is completely understandable given how severe and sudden the symptoms are. The good news is that vestibular neuritis, whilst horrible for anyone, isn't usually dangerous.

It's caused by inflammation of the nerve that connects your inner ear to your brain, and whilst recovery takes time, most people get back to normal eventually. In this article, we look at the causes, how it feels, the process of diagnosis and effective treatment.

What actually is vestibular neuritis?

Your vestibular system is responsible for your sense of balance and spatial awareness. It's located in your inner ear and constantly sends information to your brain about your head position and movement. The vestibular nerve carries these signals, where they're processed alongside information from your eyes and body to keep you balanced.

Vestibular neuritis happens when this nerve becomes inflamed, usually due to a viral infection. When the nerve isn't working properly, your brain receives confusing signals about your position and movement. The result is severe vertigo, which is the sensation that you or everything around you is spinning when it isn't.

This is different from labyrinthitis, though the two are often confused, as Labyrinthitis affects both the vestibular nerve and the cochlear nerve (which handles hearing), causing vertigo and hearing loss. Vestibular neuritis only affects the vestibular nerve, so your hearing stays normal.

However, if you're experiencing both severe vertigo and sudden hearing loss, that's usually labyrinthitis and needs urgent medical attention.

Related reading: What is sudden hearing loss?

What does it feel like?

The vertigo from vestibular neuritis isn't subtle; you don't just feel a bit dizzy when you stand up too quickly, it's an overwhelming sensation of spinning that makes it nearly impossible to function. The room appears to be rotating around you, or you feel like you're spinning even when you're lying perfectly still.

The nausea that comes with it is often severe, as your brain is receiving signals that you're moving when you're not, which triggers the same response as motion sickness. Many people experience constant nausea during the acute phase, as any head movement makes everything more intense.

Turning over in bed, looking up or down, or trying to walk all trigger worse spinning and nausea, and this is why people with vestibular neuritis often lie very still with their eyes closed, as it's the only thing that provides any relief.

You might also notice your eyes moving involuntarily, which is called nystagmus, and it happens because your brain is trying to make sense of the conflicting balance signals it's receiving.

What causes it?

Vestibular neuritis is usually triggered by a viral infection, and often, people have had a cold, flu, or upper respiratory infection in the week or two before the vertigo strikes. The virus causes inflammation of the vestibular nerve, disrupting its normal everyday function.

The most commonly implicated viruses are the same ones that cause cold sores (herpes simplex) and shingles (varicella-zoster), though other viruses can be responsible.

How is it diagnosed?

There's no single test that definitively diagnoses vestibular neuritis; instead, your doctor makes the diagnosis based on your symptoms and by ruling out other causes of severe vertigo, particularly stroke.

They'll likely perform the head impulse test, where they move your head quickly whilst you focus on their nose, and if you have vestibular neuritis, your eyes won't be able to stay locked on the target. They'll also check for nystagmus and assess your balance and coordination.

If there's any doubt about the diagnosis, particularly if you have risk factors for stroke, you might need an MRI scan to rule out problems in your brain.

Treatment and recovery

The acute phase, which is when everything is spinning violently, typically lasts for one to three days. During this time, vestibular suppressant medications like prochlorperazine can help reduce the vertigo and nausea enough to make you more comfortable. You'll likely need to stay in bed or at least remain very still.

Whilst the acute spinning usually settles within a few days, complete recovery takes a while longer. Most people go through a phase lasting weeks or months where they feel unsteady, particularly when walking or turning their head quickly.

This happens because your brain needs time to adapt to the damaged vestibular nerve and learn to rely more on information from your other ear and visual system.

Vestibular rehabilitation exercises, which are a specific type of physiotherapy, can significantly speed up this recovery process. These exercises deliberately provoke mild dizziness to help your brain adapt more quickly. It feels counterintuitive to make yourself dizzy when you're trying to recover from vertigo, but it does usually work effectively.

Most people recover fully or nearly fully within three to six months, though some are left with mild ongoing balance problems or occasional dizziness.

When to seek urgent help

If you develop sudden, severe vertigo, you should see a doctor, but some symptoms require immediate medical attention. Seek urgent help if you have severe vertigo along with sudden hearing loss, double vision, difficulty speaking, weakness on one side of your body, or a severe headache.

These could indicate something more serious, like a stroke or labyrinthitis, and if you're unsure whether your symptoms warrant urgent attention, err on the side of caution and get checked.

Related reading: What is labyrinthitis?

Key takeaways

✔️ Vestibular neuritis causes sudden severe vertigo - the room spins violently, often with severe nausea and vomiting, making it almost impossible to move.

✔️ It's usually caused by a viral infection - often following a recent cold or flu that inflames the vestibular nerve in your inner ear.

✔️ Different from labyrinthitis - vestibular neuritis doesn't affect hearing; if you have vertigo plus sudden hearing loss, that's labyrinthitis and needs urgent attention.

✔️ The worst phase lasts a few days - acute spinning typically settles within one to three days, though you'll likely feel unsteady for weeks or months afterwards.

✔️ Medications help the acute phase - vestibular suppressants and anti-sickness drugs make the initial spinning more bearable; steroids might speed recovery if given early.

✔️ Vestibular rehabilitation speeds recovery - physiotherapy exercises that deliberately provoke mild dizziness help your brain adapt faster, shortening overall recovery time.

✔️ Most people recover fully - within three to six months, most people are back to normal or close to it, though some have mild ongoing balance issues.

✔️ Seek urgent help for warning signs - if severe vertigo comes with hearing loss, double vision, weakness, speech problems, or severe headache, get immediate medical attention.

Conclusion

Vestibular neuritis causes sudden, severe vertigo due to inflammation of the nerve connecting your inner ear to your brain. It's typically triggered by a viral infection and, whilst genuinely horrible to experience, isn't usually dangerous.

The acute phase of violent spinning usually lasts a few days, but full recovery takes longer, which is typically three to six months. Vestibular rehabilitation exercises can help speed up recovery by training your brain to adapt to the damaged nerve.

If you develop sudden, severe vertigo, get it checked out with your local GP. And if you have any warning signs of stroke alongside the vertigo, seek urgent medical attention.

Getting back to normal after vestibular problems?

Recovering from vestibular neuritis can take months, and it's not uncommon for people to worry about their overall ear health afterwards.

If you'd like peace of mind that your hearing hasn't been affected, or if you've noticed any changes in how well you're hearing, your local GP can check and refer you to an audiologist.

We offer thorough hearing assessments at no cost, either in a clinic or your own home, with a local audiologist you can trust.

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