# Acute vestibular neuritis & labyrinthitis - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - Nervous System Disorders 2025 · Dimenhydrinate 50 mg tablets US OTC drug facts label (DailyMed, Time Cap Labs) · Smith T, Rider J, Cen S, Borger J. Vestibular Neuronitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: July 21, 2023. Bookshelf ID: NBK549866, PMID: 31751056. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Nervous System Disorders 2025 - Dimenhydrinate 50 mg tablets US OTC drug facts label (DailyMed, Time Cap Labs) ## Treatment metadata - Dimenhydrinate — 50 mg — oral.solid ## Complete treatment card ```text ACUTE VESTIBULAR NEURITIS & LABYRINTHITIS Sources: Egyptian National Drug Formulary - Nervous System Disorders 2025 · Dimenhydrinate 50 mg tablets US OTC drug facts label (DailyMed, Time Cap Labs) · Smith T, Rider J, Cen S, Borger J. Vestibular Neuronitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Last Update: July 21, 2023. Bookshelf ID: NBK549866, PMID: 31751056. Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Nausea, vomiting and severe spinning vertigo are the commonest complaints [nausea · vertigo · vomiting] - Pin down how many true spinning attacks there have been; general unsteadiness or lightheadedness does not fit [unsteadiness] - The peak of vertigo seldom lasts beyond 72 hours, though unsteadiness and brief spells can run for weeks [unsteadiness · vertigo] - Recovery drags on where anxiety or depression sits alongside [anxiety · low mood] - Ask about a recent viral upper respiratory infection - Ask about cholesteatoma, past ear surgery, temporal bone fracture, meningitis and otitis media SIGNS - what you find (5) - Nystagmus is usually there, with the fast phase beating away from the affected ear [nystagmus] - Gait and balance are often off, so test Romberg, tandem gait, cerebellar and meningeal signs - Rinne and Weber will usually show sensorineural loss on the affected side, so arrange formal audiology - Otoscopy may reveal the cause, such as otitis media or cholesteatoma - If bacterial meningitis is on the cards, check the skin for a non-blanching rash [purpura · rash] TESTS (9) - Labyrinthitis is a diagnosis of exclusion - Audiometry establishes whether sensorineural hearing loss is present and how severe - Specialist vestibular tests have no role acutely; they help later with compensation and residual deficit - Severe vomiting warrants a basic metabolic panel for electrolytes and hydration - Analyse the cerebrospinal fluid if bacterial meningitis is suspected - HIV and syphilis serology help in high-risk patients or an atypical picture - Consider autoimmune testing where there are systemic features, even if the titres come back negative - MRI or CT is there to pick up an alternative diagnosis - Image the cerebellopontine angle when the ears differ by more than 15 dB, as 13% of acoustic neuromas start as sudden hearing loss IF NOT THIS - what else fits (12) - Vestibular neuritis looks the same but arrives without hearing loss - Meniere disease also gives hearing loss with vertigo, but the attacks come and go - Meniere disease is marked by fluctuating fullness in the ear, tinnitus and hearing loss with the spells - BPPV gives dizziness with no hearing loss and an abnormal Dix-Hallpike test - A stroke at the back of the brain shows abnormal neurology: ataxia, hoarseness, slurred speech or trouble swallowing - Vertigo with cranial nerve deficits, tract signs or numbness suggests a brainstem stroke - Acoustic neuroma is diagnosed on gadolinium-enhanced MRI - Inner ear malformations give progressive or congenital hearing loss, seen on CT or MRI - A temporal bone fracture follows a recent head injury and is diagnosed on CT - Bleeding into the inner ear usually follows trauma and shows on MRI - A temporal bone tumour usually brings cranial nerve deficits or facial palsy, seen on MRI or CT - Multiple sclerosis carries other features such as spasticity, optic neuritis or cranial nerve deficits Source StatPearls "Labyrinthitis" - disease-level clinical article Status traced to the source above 1. DIMENHYDRINATE [1st line] Adult 50 mg 3-4 times daily as needed for acute severe vertiginous nausea (max 3 days continuous use) Peds Age restriction: minimum 24 months 2 to under 6 years: Half a tablet every 6 to 8 hours, and no more than one and a half tablets in 24 hours 6 to under 12 years: Half to one tablet every 6 to 8 hours, and no more than 3 tablets in 24 hours (children 6 to under 12 years: give 1/2 to 1 tablet every 6-8 hours; do not give more than 3 tablets in 24 hours. children 2 to under 6 years: give 1/2 tablet every 6-8 hours; do not give more than 1 1/2 tablets in 24 hours.) Source Dimenhydrinate 50 mg tablets US OTC drug facts label (DailyMed, Time Cap Labs) Why Short-term antiemetic vestibular suppressant strictly limited to initial 48-72 hours so as not to impair central compensation Caution Sedation and anticholinergic effects (dry mouth, urinary retention) can occur. Never above 400 mg in 24 hours. Alcohol, sedatives and tranquillisers all deepen the drowsiness. No driving until they know how it takes them. Ask twice before giving it in glaucoma, prostatic enlargement with difficulty passing urine, or chronic lung disease - it is an anticholinergic antihistamine and all three get worse. Egypt DRAMENEX 50MG 20 TABS. KAHIRA 28.00 EGP (1.40/unit) Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)