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Labyrinthitis

Bacterial labyrinthitis; Serous labyrinthitis; Neuronitis - vestibular; Vestibular neuronitis; Viral neurolabyrinthitis; Vestibular neuritis; Labyrinthitis - vertigo: Labyrinthitis - dizziness; Labyrinthitis - vertigo; Labyrinthitis - hearing loss

 

Labyrinthitis is irritation and swelling of the inner ear. It can cause vertigo and hearing loss.

Causes

 

Labyrinthitis is usually caused by a virus and sometimes by bacteria. Having a cold or flu can trigger the condition. Less often, an ear infection may lead to labyrinthitis. Other causes include allergies or certain drugs that are bad for the inner ear.

Your inner ear is important for both hearing and balance. When you have labyrinthitis, the parts of your inner ear become irritated and swollen. This can make you lose your balance and cause hearing loss.

These factors raise your risk for labyrinthitis:

  • Drinking large amounts of alcohol
  • Fatigue
  • History of allergies
  • Recent viral illness, respiratory infection , or ear infection
  • Smoking
  • Stress
  • Using certain prescription or nonprescription drugs (such as aspirin)

 

Symptoms

 

Symptoms may include any of the following:

  • Feeling like you are spinning, even when you are still ( vertigo )
  • Your eyes moving on their own, making it hard to focus them
  • Dizziness
  • Hearing loss in one ear
  • Loss of balance ; you may fall toward one side
  • Nausea and vomiting
  • Ringing or other noises in your ears ( tinnitus )

 

Exams and Tests

 

Your doctor may give you a physical exam. You may also have tests of your nervous system (neurological exam).

Tests can rule out other causes of your symptoms. These may include:

  • EEG
  • Electronystagmography , and warming and cooling the inner ear with air or water to test eye reflexes ( caloric stimulation )
  • Head CT scan
  • Hearing tests ( audiology/audiometry )
  • MRI of the head

 

Treatment

 

Labyrinthitis usually goes away within a few weeks. Treatment can help reduce vertigo and other symptoms. Medicines that may help include:

  • Antihistamines
  • Medicines to control nausea and vomiting, such as prochlorperazine (Compazine)
  • Medicines relieve dizziness, such as meclizine (Bonine, Dramamine, or Antivert) or scopolamine (Transderm-Scop)
  • Sedatives, such as diazepam (Valium)
  • Corticosteroids
  • Antiviral medicines

Follow your health care provider instructions about taking care of yourself at home . Doing these things can help you manage vertigo:

  • Stay still and rest.
  • Avoid sudden movements or position changes.
  • Rest during severe episodes. Slowly resume activity. You may need help walking when you lose your balance during attacks.
  • Avoid bright lights, TV, and reading during attacks. Rest during severe episodes, and slowly increase your activity.
  • Ask your provider about balance therapy. This may help once nausea and vomiting have passed.

You should avoid the following for 1 week after symptoms disappear:

  • Driving
  • Operating heavy machinery
  • Climbing

A sudden dizzy spell during these activities can be dangerous.

 

Outlook (Prognosis)

 

  • If you have severe vomiting, you may be admitted to the hospital.
  • Severe symptoms usually go away within a week.
  • Most people are completely better within 2 to 3 months.
  • Older adults are more likely to have dizziness that lasts longer.

In very rare cases, hearing loss is permanent.

 

Possible Complications

 

  • You can injure yourself or others during attacks of vertigo
  • Severe vomiting may cause dehydration

 

When to Contact a Medical Professional

 

Call your provider if:

  • You have dizziness, vertigo, loss of balance, or other symptoms of labyrinthitis
  • You have hearing loss

Call 911 or your local emergency number if you have any of the following severe symptoms:

  • Convulsions
  • Double vision
  • Fainting
  • Vomiting a lot
  • Slurred speech
  • Vertigo that occurs with a fever of more than 101°F (38.33°C)
  • Weakness or paralysis

 

Prevention

 

There is no known way to prevent labyrinthitis.

 

 

Open References

References

Baloh RW, Jen JC. Hearing and equilibrium. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 428.

Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery . 6th ed. Philadelphia, PA: Elsevier Mosby; 2015:chap 165.

Ferri FF. Labyrinthitis. In: Ferri FF, ed. Ferri's Clinical Advisor 2016 . Philadelphia, PA: Elsevier Mosby; 2016:735.

 
  • Ear anatomy

    Ear anatomy - illustration

    The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.

    Ear anatomy

    illustration

    • Ear anatomy

      Ear anatomy - illustration

      The ear consists of external, middle, and inner structures. The eardrum and the 3 tiny bones conduct sound from the eardrum to the cochlea.

      Ear anatomy

      illustration

    Self Care

     

    Tests for Labyrinthitis

     
       

      Review Date: 8/13/2015

      Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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