Overview and Facts about Labyrinthitis and Vestibular Neuritis
Labyrinthitis and vestibular neuritis occur when irritation, inflammation or infection of your inner ear affects the vestibular nerves.
These nerves are what control part of your balance system, so issues with them can cause vertigo and imbalance. Usually, labyrinthitis is not a chronic condition, meaning that symptoms disappear after a few weeks.
The main difference between vestibular neuritis and labyrinthitis is that labyrinthitis also affects hearing. While bacterial and viral infections can cause labyrinthitis or vestibular neuritis, often times an underlying cause of the condition is not identified.
Signs and Symptoms of Labyrinthitis and Vestibular Neuritis
If you have labyrinthitis or vestibular neuritis, you might notice that symptoms come on suddenly and are quite intense. Often patients are seen in the emergency room due to the intensity of the symptoms. Some of the symptoms can include:
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Vertigo (a feeling of spinning around)
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Nausea and vomiting
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Loss of balance or rocking sensation
Additionally, if you have labyrinthitis you may experience:
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Tinnitus (a buzzing or ringing in the ear)
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Being unable to hear high-pitched sounds
Normally, symptoms like vertigo, nausea and loss of balance will gradually begin to improve within the first five days. You will likely have continued imbalance that will improve over a few weeks.
Causes and Risk Factors of Labyrinthitis and Vestibular Neuritis
There are two main causes of labyrinthitis: bacteria and viruses.
Specific viral infections linked to labyrinthitis include:
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Herpes, especially the types that cause shingles, chicken pox and cold sores
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Measles
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Hepatitis
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Mumps
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Stomach viruses
As for bacterial infections, they often start because of an infection in the middle ear. The bacteria here produce toxins that inflame the inner ear. Bacterial meningitis, which is an infection of the brain and spinal cord, can also be a cause.
You may be at increased risk of developing labyrinthitis if you:
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Smoke a lot
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Have a lot of stress
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Drink a lot of alcohol
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Have allergies
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Take prescription medications
Tests and Diagnosis of Labyrinthitis and Vestibular Neuritis
Seeing an otolaryngologist, or doctor specializing in diseases of the ear, nose and throat, is your best option for discovering if you have labyrinthitis.
The otolaryngologist will take a detailed history and perform perform a physical exam. and conduct a few tests to try and determine the cause of your symptoms. Such tests could include:
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Audiogram (hearing test)
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An in-office vestibular examination
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Videonystagmography: this is an in-depth test to learn more about the strength of your balance system
Treatment and Care of Labyrinthitis and Vestibular Neuritis
The treatment of labyrinthitis and vestibular neuritis is different in the early and later stages.
Early treatment: (first week of symptoms)
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Supportive care along with medication will help symptoms including anti-nausea medication and vestibular suppressant medication
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Stay hydrated while avoiding alcohol, tobacco and caffeine
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Antibiotics or antivirals may be given if an infection is identified
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Avoiding quick movements
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If hearing loss is detected, oral steroids or steroid ear injections may be recommended
Later treatment: (after first week of symptoms)
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Ending vestibular suppressant medication use
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Slowly resume normal activities
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Your doctor may recommend a course of vestibular physical therapy or home exercises which can help the balance system recover
Following these care tips and the advice of your doctor, most individuals see symptoms clear up within three to six weeks.
