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Labyrinthitis and Vestibular Neuritis

Topic Overview

What are labyrinthitis and vestibular neuritis?

Labyrinthitis (say "lab-uh-rin-THY-tus") is a problem inside the inner ear. It happens when the labyrinth, a part of the inner ear that helps control your balance, gets swollen and inflamed.

Vestibular neuritis is an inflammation of the vestibular nerve. The nerve is located in the inner ear. It carries signals that help with your balance from the inner ear to the brain.

The inflammation of either condition may cause sudden vertigo. This makes you feel like you're spinning or whirling. Labyrinthitis may also cause temporary hearing loss or a ringing sound in your ears.

The two problems have similar symptoms and treatment. However, if you have both sudden vertigo and hearing loss, you need urgent care to rule out a stroke.

See pictures of the inner ear showing the labyrinth and an inflamed vestibular nerve.

What causes labyrinthitis and vestibular neuritis?

The causes of labyrinthitis and vestibular neuritis are not clear. They can happen after a viral infection or, more rarely, after an infection caused by bacteria. The trigger may be an upper respiratory infection, such as the flu or a cold. Less often, it may start after a middle ear infection.

The infection inflames the vestibular nerve. This causes the nerve to send incorrect signals to the brain that the body is moving. But your other senses (such as vision) don't detect the same movement. The confusion in signals can make you feel that the room is spinning or that you have lost your balance (vertigo).

What are the symptoms?

The main symptom of both labyrinthitis and vestibular neuritis is vertigo. Vertigo is not the same as feeling dizzy. Dizziness means that you feel unsteady or lightheaded. But vertigo makes you feel like you're spinning or whirling. It may make it hard for you to walk. Symptoms of vertigo and dizziness may be caused by many problems other than labyrinthitis and vestibular neuritis.

Vertigo begins without warning. It often starts 1 to 2 weeks after you've had the flu or a cold. It may be severe enough to make you vomit or make you feel sick to your stomach. Vertigo slowly goes away over a few days to weeks. But for a month or longer, you may still get vertigo symptoms if you suddenly move your head a certain way.

Labyrinthitis may also cause hearing loss and a ringing sound in your ears (tinnitus). Most often, these symptoms don't last for more than a few weeks.

How are labyrinthitis and vestibular neuritis diagnosed?

Your doctor can tell if you have labyrinthitis or vestibular neuritis by doing a physical exam and asking about your symptoms and past health. Your doctor will look for signs of viral infections that can trigger labyrinthitis.

If the cause of your vertigo is not clear, your doctor may do other tests, such as electronystagmography or an MRI to rule out other problems.

How are labyrinthitis and vestibular neuritis treated?

Most of the time, labyrinthitis and vestibular neuritis go away on their own. This normally takes several weeks. If the cause is a bacterial infection, your doctor will give you antibiotics. But most cases are caused by viral infections, which can't be cured with antibiotics.

Your doctor may prescribe steroid medicines, which may help you get better sooner. He or she may also give you other medicines, such as antiemetics, antihistamines, and sedatives, to help control the nausea and vomiting caused by vertigo.

Vertigo usually gets better as your body adjusts (compensation). Medicines like antihistamines can help your symptoms, but they may make it take longer for vertigo to go away. It's best to only use medicines when they are needed and for as little time as possible.

Staying active can help you get better. Check with your doctor about trying balance exercises at home. These include simple head movements and keeping your balance while standing and sitting. They may reduce symptoms of vertigo.

References

Other Works Consulted

  • Hillier SL, McDonnell M (2011). Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database of Systematic Reviews (2).
  • Johnson J, Lalwani AK (2012). Vestibular disorders. In AK Lalwani, ed., Current Diagnosis and Treatment in Otolaryngology-Head and Neck Surgery, 3rd ed., pp. 729-738. New York: McGraw-Hill.
  • Walker MF, Daroff RB (2015). Dizziness and vertigo. In DL Kasper et al., eds., Harrison's Principles of Internal Medicine, 19th ed., vol. 1, pp. 148-151. New York: McGraw-Hill Education.

Credits

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical ReviewerKarin M. Lindholm, DO - Neurology

Current as ofMay 4, 2017


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