Acute Vestibular Syndrome — Vestibular Neuritis vs Labyrinthitis

Overview

A practical, on-call focused approach to the patient presenting with acute continuous vertigo, vomiting, spontaneous nystagmus, and gait instability. This card is not a general “peripheral versus central vertigo” chapter; it is a decision tool for the acute vestibular syndrome itself: is this vestibular neuritis, labyrinthitis, AICA stroke, bacterial inner-ear infection, or meningitis until proven otherwise? The rule for the shift is simple: do not label every continuous vertigo as “viral vestibulopathy,” do not miss the hearing component, do not overuse vestibular suppressants, and do not ignore a central HINTS pattern even when early imaging...