Case · Foundation · Vestibular neuritis
Acute persistent vertigo, no risk factors
32-year-old, no vascular risk factors. Preceding viral URTI one week earlier.
Vignette
A 32-year-old woman presents with 18 hours of continuous vertigo, nausea, and unsteadiness. She cannot walk unaided. Symptoms began acutely at rest. She had a flu-like illness one week ago. No headache, no hearing change, no focal neurology. Vascular risk factors: none.
Diagnostic question
Which single management step is most appropriate next?
Teaching point
A complete and unambiguous peripheral HINTS triad in acute vestibular syndrome — abnormal head impulse, unidirectional nystagmus, absent skew — is consistent with vestibular neuritis. Vascular risk factors and HINTS-plus (auditory) features must still be considered before the case is closed.