Vestibular neuronitis: an uncommon diagnosis in the pediatric age group

Two weeks after an upper respiratory infection, a ten year old boy presente d with vomiting, vertigo, and spontaneous nystagmus, suggesting an elevatio n of intracerebral pressure. However, caloric testing revealed unilateral d epression of labyrinthine function,while cerebrospinal fluid and a magnetic nuclear imaging scan of the brain were normal. Therefore we made the diagn osis of vestibular neuronitis. The disease was self-limited within several days. Vestibular neuronitis has an incidence of 4:1 00000 and occurs predom inantly at the age of 40-50 years. Only 5% of the affected patients are chi ldren. The disease is regarded as the vestibular counterpart of sudden hear ing loss. Diagnostic criteria are vertigo,decreased reaction Co caloric sti mulation of the labyrinth, absent abnormality of cochlear and central nervo us system. Causative factors are infectious, cardiovascular, metabolic, and toxic affections. A preceeding upper respiratory infection appears in up t o 60% of affected children. The prognosis for complete recovery is excellen t in children. Discussion: We report a classical case of vestibular neuronitis in childhoo d. This uncommon disease in the pediatric age group should be considered wh en an elevation of intracerebral pressure is suspected.