This protocol addresses the clinical scenario in which first-line treatment for vestibular neuronitis has been administered but the expected symptomatic milestones have not been reached — requiring a structured next step.
Initial management typically includes vestibular suppressants, antiemetics, fluid support, a high-dose glucocorticoid, and vestibular rehabilitation exercises. Escalation is indicated when:
When the expected response to initial therapy is not achieved, the next step involves dose adjustment of the same classes of agents — vestibular suppressants and antiemetics. The treatment response in this setting is dose-dependent. The complete decision algorithm, including specific considerations, is available in the full protocol.