Article Text

Download PDFPDF
Vestibular neuronitis after COVID-19 vaccination
  1. Solange Bramer1,
  2. Yvette Jaffe1 and
  3. Aravinth Sivagnanaratnam2
  1. 1Faculty of Medicine, Imperial College London, London, UK
  2. 2Stroke, London North West University Healthcare NHS Trust, Harrow, Middlesex, UK
  1. Correspondence to Dr Aravinth Sivagnanaratnam; a.sivagnanaratnam{at}


A woman in her 50s presented with acute vertigo and vomiting within 72 hours of receiving the Pfizer-BioNTech COVID-19 vaccine. The only neurological deficit was an impaired vestibulo-ocular reflex with horizontal nystagmus. The patient was subsequently diagnosed with vestibular neuronitis. She was managed symptomatically with prochlorperazine and betahistine, and underwent vestibular rehabilitation for 6 weeks. She made a full recovery and experienced no further symptoms. She received the second dose of the vaccine without complications.

This case demonstrates a temporal association between COVID-19 vaccination and vestibular neuronitis. Neurological adverse events are rare but recognised side effects of COVID-19 vaccines and healthcare professionals should be aware of them. This ensures timely management of patients with such presentations. Treatment should be the same as for non-vaccine-associated vestibular neuronitis. The nature of the relationship between COVID-19 vaccination and vestibular neuronitis remains unclear and patients therefore require investigations to exclude other recognised causes of vestibular neuronitis.

  • COVID-19
  • Cranial nerves
  • Neurology (drugs and medicines)
  • Public health
  • Unwanted effects / adverse reactions

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors SB and YJ took a history from the patient. The three authors examined the patient. SB and YJ wrote the initial version of the manuscript together. AS oversaw the writing of the manuscript and provided guidance throughout the process. All three authors revised the manuscript and approve of the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.