Labyrinthitis usually refers to an infection of the inner ear. Other names for this condition are vestibular neuritis, vestibular neuronitis and neurolabyrinthitis. Hearing may be affected, and when it is, the term labyrinthitis is used.
- Inner ear virus
- Flu-like respiratory illness
- Stomach virus with gastrointestinal symptoms
- Epidemics of labyrinthitis can occur so that many people in the same town can be affected with an attack of vertigo.
- Occasionally, a herpes virus, which also causes cold sores, shingles or the chicken pox
- Bacterial or other infectious organisms, for example the organism that causes lyme disease
- Immediate onset
- Severe vertigo
- Nausea and vomiting
- Loss of hearing in high frequency range
- Tinnitus, or ringing in the ear
Symptoms typically reach their maximum intensity relatively quickly, and may be constant and incapacitating for several days. This can lead to dehydration and extreme exhaustion. After a few days, symptoms begin to subside. Then, they are triggered by sudden head movements.
To refine the diagnosis, other conditions must be ruled out, including:
- Benign paroxysmal positional vertigo
- Ménières syndrome
- Vestibular migraine
- Damage to arteries in neck
- Generalized inflammation or infection
- Small stroke
- Hemorrhage in labyrinth or brain, particularly if a patient has risk factors for stroke, such as smoking, high cholesterol, obesity, heart disease, hypertension or high blood pressure or a strong family history of heart disease or stroke.
An MRI or CT scan is often necessary, as well as appropriate blood work to test vestibular impaired function.
Recovery from labyrinthitis may be slow, taking several weeks or months. For most patients, however, recovery is complete. Usually, after a few weeks or months, a positional vertigo syndrome occurs, in which vertigo occurs when turning over in bed or tilting the head way up or down. This can be easily treated with physical therapy.
Treatment for an acute attack of labyrinthitis depends upon the cause. If a bacterial cause is excluded, antiviral medications or anti-inflammatory medications or cortisone-like drugs may be prescribed. Symptomatic medications for vertigo or nausea, such as Meclizine or Antivert, are used. Sedative medications are best avoided.
Exercise activities are encouraged to help the body compensate for any loss of function and to adapt to its new balance requirements. Specialized vestibular physical therapy programs are sometimes used to speed recovery.
Recurrences, typically milder, may occur. This usually indicates a need to search for another diagnosis. By and large, long term prognosis for labyrinthitis patients is good and most patients make a complete recovery.