Labyrinthitis and Vestibular Neuritis


The labyrinth is in the inner ear. The inner ear includes the cochlea, vestibule and and semicircular canals. These are small shell-like structures in which there is a system of narrow fluid-filled channels called the labyrinth. The semicircular canals sense movement of your head and help to control balance and posture. The cochlea is concerned with hearing.
There are three semicircular canals (anterior, lateral and posterior). These are roughly at right angles to each other and sense movement in different directions - left-right, forward-back, and up-down head movements.

What is vestibular neuritis and labyrinthitis?

Vestibular neuritis means inflammation of the vestibular nerve. This is the nerve that comes from the inner ear and takes messages from the semicircular canals to the brain.
Labyrinthitis is a condition that is due to inflammation of the labyrinth in the inner ear, although sometimes the vestibular nerve is also involved.

The causes and symptoms of labyrinthitis and vestibular neuritis are similar. If hearing is affected in addition to other symptoms listed below, then labyrinthitis is much more likely than vestibular neuritis.

What are the causes of labyrinthitis and vestibular neuritis?

  • Viral infection
  • Bacterial infection in the middle ear.
  • Meningitis.
  • A blockage of the blood circulation to part of the brain.
  • Injury to the ear.
  • Allergies.
  • Tumours.
  • An uncommon side-effect of some drugs.

What are the symptoms of labyrinthitis and vestibular neuritis?

  • Vertigo
  • The main symptom is vertigo. Vertigo is dizziness with a spinning sensation.
  • Some mild hearing loss on the affected side if you have labyrinthitis.
  • Nystagmus. This is a 'shaking' of the eyes from side to side or in a rotary movement.
  • Pain in an ear. If you have ear pain it may indicate that you have a bacterial middle ear infection that has spread to the inner ear.

Do I need any tests?

Your doctor will usually be able to diagnose this on the basis of your symptoms and the examination. Tests are not usually needed or helpful.However, you may be referred for tests such as a scan, hearing tests, balance tests, etc, if you have symptoms that suggest anything other than a viral infection, or if symptoms are not settling within 3-4 weeks.

What is the treatment for labyrinthitis and vestibular neuritis?

Treatment if a viral infection is the cause

No treatment will completely take away the symptoms - especially the main symptom of vertigo. You may simply have to accept that you will be dizzy, and may need to stay in bed until the viral infection runs its course and the worst of the symptoms subside.

Some doctors prescribe a short course of steroid tablets. If symptoms do not clear within a few weeks then you may be referred to an ear specialist who may recommend treatment called vestibular rehabilitation therapy (VRT).

What is the prognosis?

A bout of labyrinthitis or vestibular neuritis can make you feel very unwell, and put you to bed. However, in most cases, the cause is a viral infection and this usually clears away. Therefore, symptoms in most cases clear completely but this may take several weeks. Some cases are milder and you just feel a bit unsteady on your feet for a short time.

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