Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms

Neurol Clin. 2015 Aug;33(3):699-716, xi. doi: 10.1016/j.ncl.2015.04.002.


Most patients with the acute vestibular syndrome (AVS) have vestibular neuritis or stroke or, in the setting of trauma, a posttraumatic vestibular cause. Some medical and nonstroke causes of the AVS must also be considered. Multiple sclerosis is the most common diagnosis in this group. Other less common causes include cerebellar masses, inflammation and infection, mal de debarquement, various toxins, Wernicke disease, celiac-related dizziness, and bilateral vestibulopathy. Finally, there may be unmasking of prior posterior circulation events by various physiologic alterations such as alterations of temperature, blood pressure, electrolytes, or various medications, especially sedating agents.

Keywords: Acute vestibular syndrome; Dizziness; Multiple sclerosis; Neurologic disease; Stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Acute Disease
  • Brain Neoplasms / complications
  • Cerebellar Diseases / complications
  • Diagnosis, Differential
  • Dizziness / etiology*
  • Drug-Related Side Effects and Adverse Reactions
  • Encephalitis / complications
  • Humans
  • Multiple Sclerosis / complications
  • Stroke / complications
  • Vertigo / etiology*
  • Vestibular Diseases / diagnosis*
  • Vestibular Diseases / etiology*
  • Vestibular Neuronitis / complications