COVID and Vestibular Neuritis: Why the Room Won't Stop Spinning After Your Infection
Had COVID and now the world is spinning? You might have vestibular neuritis. Here's what's happening, what helps, and when you'll feel normal again.
Quick Facts
- 76% complete recovery with early steroids vs 27% without
- COVID can directly infect inner ear tissue via ACE2 receptors
- 2-9x increased risk after COVID infection
- Vestibular rehabilitation has Level 1 evidence
Feeling awful right now?
76% of people recover completely with the right treatment. This is temporary.
What to do right now:
- 1Find a safe spot. Lie down if you can. The floor is fine.
- 2Fix your eyes on something still — a doorknob, a corner, anything not moving.
- 3Breathe slowly. In for 4, out for 6. Your body thinks you're in danger. You're not.
- 4Don't fight the nausea. If you need to throw up, that's okay. It passes.
- 5Call someone. You're not dying, but you shouldn't be alone right now.
This usually peaks within The absolute worst is usually 24-72 hours. It WILL get better., then steadily improves.
Quick Summary
- Your balance nerve got inflamed, probably from COVID. It's sending garbage signals.
- Your brain is getting conflicting info from your ears. That's why everything spins.
- This is treatable. Most people recover fully. You need steroids fast and rehab later.
With proper treatment, 76% make a complete recovery. That's really good odds.
Ready when you are
When you're feeling a bit steadier, specific exercises can help your brain adapt and reduce your symptoms. We'll guide you through them step by step — no experience needed.
Start exercisesStruggling to stay consistent?
We'll send you a gentle reminder each week with exercises for covid and vestibular neuritis: why the room won't stop spinning after your infection — just enough to keep you on track.
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You woke up and the ceiling was spinning. Or maybe you got up to use the bathroom and the floor tilted sideways and you ended up grabbing the wall. Maybe you’re reading this from the bathroom floor right now because you can’t make it back to bed. First: you’re going to be okay. What you have is terrifying but not dangerous. And yes, it might be connected to that COVID infection you had recently.
What’s Actually Happening
Deep inside your ear, there’s a nerve that sends balance signals to your brain. It’s like a live GPS feed — constantly telling your brain which way is up, whether you’re moving, and how fast.
When that nerve gets inflamed (usually from a virus), it starts sending garbage data. Or no data at all. Meanwhile, your other ear is sending perfectly normal signals.
Your brain is now getting two completely different stories about reality. One ear says “we’re still.” The other says “we’re spinning wildly.” Your brain panics. That panic is vertigo.
Think of it like a phone line between your ear and brain that suddenly has massive static. Your brain can’t make sense of the signal, so it assumes the worst: something is very wrong. That’s why you feel like you’re dying even though you’re not.
The COVID connection: The virus that causes COVID can directly infect your inner ear tissue. It has special receptors there — the same ones it uses to get into your lungs. Once inside, it causes inflammation that squeezes your balance nerve. That’s why vestibular problems after COVID are 2-9 times more common than in people who never got infected.
Is This What I Have?
The Telltale Signs
Classic COVID-Associated Vestibular Neuritis
- •Spinning that doesn't stop — not just when you move your head
- •Nausea and vomiting, often severe for the first 24-48 hours
- •You keep falling or veering to one side when you try to walk
- •Your eyes are jerking in a rhythmic way you can't control
- •Had COVID recently (usually 1-6 weeks before)
What Makes This Different From Other Dizzy Things
| If You Have | It’s Probably |
|---|---|
| Spinning only when you roll over or look up, lasting seconds | BPPV (crystals in your ear) — different and easier to fix |
| Episodes that come and go with hearing changes | Ménière’s disease |
| Lightheadedness when standing that goes away lying down | POTS or blood pressure issue — not your inner ear |
| Spinning plus significant hearing loss | Labyrinthitis (related but includes hearing) |
What You WON’T Have If It’s Really Vestibular Neuritis
- Major hearing loss. If your hearing dropped significantly along with the vertigo, that’s a different diagnosis
- Spinning that comes and goes. Vestibular neuritis is constant at first, not episodic
- Symptoms only triggered by position changes. That’s BPPV, which is actually easier to treat
When to Get Help NOW
These Symptoms Need Emergency Evaluation
- ⚠Severe headache that came on suddenly with the vertigo
- ⚠Trouble speaking — words coming out slurred or wrong
- ⚠Weakness or numbness in your face, arm, or leg
- ⚠Double vision or loss of part of your visual field
- ⚠Difficulty swallowing
- ⚠You have high blood pressure, diabetes, or heart disease AND sudden severe vertigo
Call 911 or go to the ER if you have these symptoms. There’s one specific type of stroke that can look exactly like vestibular neuritis. It’s rare, but it’s serious.
See a doctor within 24-72 hours if: You have the classic vestibular neuritis pattern (constant vertigo, no hearing loss, no stroke symptoms) BUT you want steroids. There’s a 72-hour window where steroids dramatically improve your recovery odds. Don’t sleep on this.
How We Fix This
Steroids — The Game Changer
- •Reduces the inflammation squeezing your balance nerve
- •Like releasing a kink in a garden hose — signals can flow again
- •About 3 weeks of medication, tapering down
- •Side effects (sleep issues, mood swings) go away when you stop
- •MUST start within 72 hours for full benefit
Vestibular Rehabilitation — The Other Half
- •Teaches your brain to work around the damage
- •Specific exercises forcing brain to relearn balance
- •Start once acute spinning calms (day 3-5)
- •COVID cases may need longer rehab courses
- •Not just 'exercises' — specialized physical therapy
What Doesn’t Work (Save Your Money and Hope)
-
Antiviral medications — This seems like it should work. It’s caused by a virus! But clinical trials showed no benefit from valacyclovir or other antivirals. Don’t bother.
-
Meclizine or Dramamine beyond 3 days — This is the most common mistake. These drugs suppress your vestibular system, which feels good short term but actually PREVENTS your brain from learning to compensate. They make recovery slower, not faster. Use them for the first 2-3 days only, then stop.
-
Betahistine — Popular in Europe, but the evidence is weak. Probably doesn’t help.
-
“Just waiting it out” without steroids — If you’re in the 72-hour window, you’re throwing away a major advantage.
What Recovery Actually Looks Like
Days 1-3: The Storm
This is the worst of it. You can't stand. You're probably vomiting. The room is a permanent carousel.
- •Stay safe — falls are the real danger
- •Take suppressants if prescribed — but ONLY these 3 days
- •Stay hydrated, small sips
- •This phase ends, usually 24-72 hours
Days 4-7: The Fog Lifts
Constant spinning fading. Can probably walk with support. Still feel drunk or hungover.
- •STOP the vestibular suppressants — seriously
- •Start doing simple head movements
- •Get up and move around
- •Lying in bed all day delays recovery
Weeks 1-4: Getting Your Sea Legs
You're functional again. Quick head movements still feel off. Grocery stores might feel overwhelming.
- •Can probably go back to work (desk work)
- •Keep up vestibular exercises
- •Don't avoid activities that make you a little dizzy
- •Controlled exposure is how you heal
Months 1-3: The New Normal
Symptoms minimal or gone for most. Some have mild residual wobbliness with fast head turns.
- •COVID cases may have lingering fatigue
- •Postural stability may take extra time
- •That's a pattern we're seeing
- •You're still recovering
Important Statistics
Still Stuck? Here’s Why
If you’re past the 6-week mark and not improving — or you got better and then got stuck — here are the common reasons.
Common Reasons Recovery Stalls
Check these first
- •Still taking vestibular suppressants (stop them!)
- •Developed PPPD (brain stuck in 'alert mode')
- •Autonomic issues like POTS (especially if COVID-related)
- •Never did vestibular rehab
- •Avoiding movement that makes you dizzy
The Fixes
Evidence-based solutions
- •Wean off suppressants with doctor's guidance
- •PPPD needs SSRIs, modified rehab, and CBT
- •POTS needs separate evaluation and treatment
- •Find a vestibular-trained physical therapist
- •Controlled exposure is how you heal
The COVID-Specific Complications
Why am I still dizzy when my tests came back normal?
This is really common and frustrating with COVID-related cases. A few possibilities:
- Your brain is still learning to compensate — takes time, especially with Long COVID fatigue
- You developed PPPD — a chronic dizziness pattern where your brain got stuck in “alert mode”
- You have autonomic issues — POTS or dysautonomia causing lightheadedness on top of vestibular stuff
None of these mean you’re imagining it. They just need different approaches.
Who Can Help
Primary Care or Urgent Care
Areas of Expertise:
- •Getting steroids started within 72 hours
- •Ruling out stroke
- •Initial diagnosis
Vestibular Physical Therapist
Areas of Expertise:
- •Vestibular rehabilitation exercises
- •Post-COVID vestibular issues
- •Customized exercise programs
Neurotologist or Otoneurologist
Areas of Expertise:
- •Complex cases
- •Persistent symptoms
- •Advanced testing
The Bottom Line
Your balance nerve got inflamed — probably from COVID — and it’s sending chaos to your brain. That’s why the world is spinning and you feel like you’re dying. You’re not dying. This is temporary.
Here’s what matters:
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If you’re in the first 72 hours: Get steroids. The difference between treated and untreated is 76% vs 27% complete recovery. Don’t wait.
-
After the acute phase: Start vestibular rehab. Stop the suppressant medications. Movement is medicine — even when it feels weird.
-
If you’re not improving by 6 weeks: Something else might be going on. PPPD, autonomic issues, or incomplete compensation. See a specialist.
76% of people recover completely with proper treatment. Most of the rest have mild symptoms that don’t impact daily life. Your brain is remarkably good at rewiring itself around damage — but you have to give it the chance.
The spinning stops. I promise.
Common Questions
Questions we hear from people just like you
No. I know it feels catastrophic — the spinning, the vomiting, the complete loss of control. Your body is freaking out because your balance system went haywire. But vestibular neuritis itself isn't dangerous. The main risk is falls, so stay put until you can walk safely.