Vestibular neuritis is due to viral attack i.e. self limited disease characterized by vertigo associated with nausea +/- vomiting. Caloric test can determine the affected side revealing vestibular dysfunction (canal paresis or paralysis). Betahestadine (Betaserc 24 mg bd) can attenuate its current vertigo & follow up with new caloric test to determine the improvement.

Vestibular Neuritis is caused by an infection to the vestibular nerve and is diagnosed based on absence of cochlear symptoms and presence of vestibular symptoms. Since we know there are two branches of vestibular nerve: the superior and the inferior vestibular nerve, there could a vestibular neuritis of the SVN or the IVN or there could be a mixed neuritis. If there is aa involvement of the SVN then the caloric test will show a hypoactive response and the oVEMPs will be absent, if there is only IVN involvement then the caloric test will be normal and cVEMP will be absent. But if it is a mixed neuritis then calorics, cVEMPs and oVEMPs all the three will b absent.

Bedside examination: Fixed direction (healthy ear) horizontal-torsional spontaneous nystagmus, positive Halmagyi maneuver, no or minor vertical skew deviation, Romberg test with veering towards afected ear.

Caloric test: hypofunction in the affected ear (canal paresis > 22%) in superior or mixed neuritis; normal in inferior VN.

Smooth pursuit: normal although interfered by spontaneous nystagmus.

Gaze testing: spontaneous nystagmus that increases when looking in the direction of the fast phase and decreases when fixating.

Head Shake: increases spontaneous nystagmus.

In either case, I think it is most useful to perform a v-HIT examination. You will find a decreased gain in the afected canal with overt/covert saccades. v-HIT it is also preferred for follow-up and monitor recovery.

Thank you all very much for your contributions

I would consider the most important topic: vestibular neuritis or central pseudoneuritis. Use the HINTS algorytm! In case of peripheral neuritis: Head Impulse positive on the affected side,  horizontal-torsional spontaneous Nystagmus (slow phases toward the affected ear), Test of Skew:ocular Hypotropia on the affected side. I would add: a simultaneous ice test which inhibits or inverts the spontaneous nystagmus.