Labyrinthitis and Vestibular Neuritis

What are labyrinthitis and vestibular neuritis?

Labyrinthitis is an inflammation of the inner ear. Vestibular neuritis is an inflammation of the nerves connecting the inner ear to the brain.

The inner ear is made up of a system of fluid-filled tubes and sacs called the labyrinth. The labyrinth contains an organ for hearing called the cochlea. It also contains the vestibular system, which helps you keep your balance.

What is the cause?

These conditions often, although not always, happen after a cold. Another virus similar to the herpes virus can cause an infection in both the vestibular system and the labyrinth. This infection causes swelling and inflammation of either the vestibular nerves or the labyrinth. Sometimes labyrinthitis is caused by bacteria from a middle ear infection.

What are the symptoms?

Symptoms of vestibular neuritis and labyrinthitis are:

• dizziness or vertigo (feeling like the room is spinning)
• trouble keeping your balance
• nausea

Vestibular neuritis and labyrinthitis are rarely painful. If you have pain with dizziness, get checked right away.

After a few days, the symptoms may decrease so that you have symptoms only when you move suddenly. A sudden turn of the head is the most common movement that causes symptoms.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and examine you. Often, no other testing is needed. However, if your symptoms last for more than a month, see your healthcare provider again. Let your provider know if your symptoms are getting worse or if you are having new symptoms, such as a loss of hearing or headache.

You may have the following tests:

• A hearing test.
• An electronystagmogram (ENG). The ENG checks eye movements as a way to get information about the vestibular system. The ENG also measures the effect of head position on dizziness.
• An MRI scan to make sure that you have not had a stroke or brain tumor.
• Blood tests to check for conditions such as diabetes, thyroid disorders, Lyme disease, or blood vessel disease.

What is the treatment?

Your healthcare provider may prescribe medicines to reduce nausea and dizziness. The medicines often cause drowsiness, so you may not be able to keep your usual schedule or do your usual activities.

If your nausea and vomiting cannot be controlled, you may need to go to the hospital.

If you have an infection, you may also take medicine to treat the infection.

How long do the effects last?

It usually takes 3 to 4 weeks to recover from vestibular neuritis or labyrinthitis. You will probably need bed rest for 1 or 2 weeks. You may be left with some mild dizziness when you move your head, which can last for several years. Usually vestibular neuritis happens no more than once in a lifetime.

How can I take care of myself?

• If you are having a lot of nausea, drink clear fluids only, such as water, weak tea, and bouillon. You may need to sip liquids or only drink small amounts often until the nausea gets better. Eat bland foods such as soda crackers, toast, plain pasta, noodles, bananas, and baked or boiled potatoes.
• When you are feeling dizzy, avoid stairs, heights, and driving, and do not operate machinery.

What can I do to help prevent vestibular neuritis and labyrinthitis?

For some people, getting prompt antibiotic treatment of a middle ear infection may prevent labyrinthitis. There is no known way to prevent infections of the inner ear caused by viruses.