Vestibular neuritis characteristically spares which branch of the vestibular nerve, and what does this produce clinically?

• A Superior vestibular nerve is spared; saccular function is preserved
• B Cochlear nerve is involved equally; always accompanied by hearing loss
• C Posterior semicircular canal nerve is spared; Dix-Hallpike test remains negative
• D Inferior vestibular nerve (saccular branch) is typically spared; VEMP responses are preserved ✓

Explanation

Vestibular neuritis predominantly affects the superior division of the vestibular nerve (innervating the utricle and superior/horizontal semicircular canals), while the inferior division (saccular branch, innervating the saccule and posterior semicircular canal) is relatively spared. This is attributed to the superior division's longer and narrower bony canal, making it more vulnerable to ischaemic/inflammatory oedema. Clinically, cervical VEMP (c-VEMP) responses mediated by the saccule remain intact in most cases of vestibular neuritis.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.