Labyrinthitis and vestibular neuritis

About vestibular neuritis and labyrinthitis

Vestibular neuritis (or vestibular neuronitis) and labyrinthitis are disorders that result in inflammation of the inner ear and/or the nerve connecting the inner ear to the brain. Generally caused by a viral infection, these conditions cause vertigo (usually experienced as a spinning sensation), dizziness, imbalance, unsteadiness and sometimes problems with vision or hearing.

In a healthy balance system, the brain combines messages sent by the balance control systems in both ears, but if one side is affected, the messages from that side are distorted, causing symptoms of dizziness and vertigo.

Symptoms of labyrinthitis and vestibular neuritis

Symptoms of vestibular neuritis include a sudden onset of a constant, intense spinning sensation that is usually disabling and requires bed rest. It is often also linked with nausea, vomiting, unsteadiness, imbalance, difficulty with vision and the inability to concentrate.

While neuritis affects only the inner ear balance apparatus, labyrinthitis also affects the inner ear hearing apparatus and/or the cochlear nerve, which transmits hearing information. This means that labyrinthitis may cause hearing loss and/or ringing in the ears (tinnitus).

Causes of labyrinthitis and vestibular neuritis

The most common causes of vestibular neuritis and labyrinthitis are viral infections, often resulting from a systemic virus such as influenza (flu) or the herpes viruses, which cause chickenpox, shingles and cold sores. Bacterial labyrinthitis can start from an untreated middle ear infection, or in rare cases, as a result of meningitis.

The infections that cause vestibular neuritis and labyrinthitis may resolve without treatment within a few weeks. However, if the inner ear is permanently damaged by the infection and the brain does not adequately compensate, symptoms can persist.

Diagnosis of labyrinthitis and vestibular neuritis

Labyrinthitis and vestibular neuritis can be diagnosed based on:

• your medical history
• answers to questions about the initial onset of the symptoms
• your current symptoms
• a physical examination
• results of balance and hearing tests carried out by an audiologist.

Treatment for labyrinthitis and vestibular neuritis

Vestibular neuritis can be treated with corticosteroids (a type of anti-inflammatory medication) in the early stages, and, if necessary, with medication to reduce nausea and vertigo.

The treatment of labyrinthitis depends on the likely cause. If symptoms persist, a specialist physiotherapist can use vestibular rehabilitation exercises to retrain the brain to interpret the distorted balance messages being transmitted from the damaged inner ear and improve symptoms.

Self-care at home for labyrinthitis and vestibular neuritis

If your treatment involves vestibular rehabilitation exercises, it is important to continue the exercises at home for as long as you are advised to.

It is vital to keep moving, despite dizziness or imbalance, even though sitting or lying may be more comfortable. The aim is to return to your previous activity, work or sport, without restricting movements.

Where to get help

• Your GP (doctor)
• Balance Disorders and Ataxia Service, Neuro-otology Investigation Unit, The Royal Victorian Eye and Ear Hospital Tel. (03) 9929 8270
• Balance and Hearing Centre Tel. (03) 9662 2221