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Labyrinthitis

by Rick Alan

En Español (Spanish Version)

Definition

Labyrinthitis is swelling and irritation in the inner ear. It occurs in the labyrinth of the ear. This is a system of cavities and canals. They affects hearing, balance, and eye movement.

Labyrinthitis

Causes

Labyrinthitis may be caused by:

Viral or bacterial infection
Head injury
Disease of blood vessels
Stroke
Nerve problems
Autoimmune disease
Side effects of drugs, including:
- Certain antibiotics
- Aspirin
- Quinine—may be used for malaria treatment

Risk Factors

Factors that increase your risk for labyrinthitis include:

Current or recent viral infection (especially a respiratory infection)
Allergies
Smoking
Drinking too much alcohol
Stress

Symptoms

The symptoms can range from mild to severe and last for days or many weeks. Symptoms are usually temporary, but rarely, can become permanent.

The most common symptoms are:

Vertigo (spinning sensation)
Dizziness

Other symptoms may include:

Fatigue
Nausea and vomiting
Hearing loss
Involuntary eye movement
Ringing in the ear (tinnitus)

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Initial diagnosis is based on the symptoms and the results of your exam.

Tests may include:

Examination of the middle ear for signs of a viral or bacterial infection
Neurologic examination
Maneuvers for evaluating for other causes of dizziness (Dix-Hallpike maneuver)
Hearing tests
Electronystagmogram—a test of eye movement
CT scan or MRI scan —to look at structures in the head

Treatment

Treatment may include:

Medication to control the symptoms, including:

Antiemetics—to control nausea and vomiting
Vestibular suppressants—to limit loss of balance and dizziness
Steroids—in limited situations, to help control inflammation

Anti-viral medication may be given if a virus is involved. Antibiotics may be given if a bacterial infection in involved.

Note: Without antibiotic treatment, labyrinthitis caused by a bacterial infection can lead to permanent hearing loss or balance problems.

Some steps to help you manage your symptoms include:

Rest, lie still with your eyes closed in a darkened room during acute attacks.
Avoid movement, especially sudden movement, as much as possible.
Avoid reading.
Resume normal activities gradually after the symptoms have cleared.

Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.

In some cases, nausea and vomiting cannot be controlled. This can result in severe dehydration. You may need hospitalization to receive fluids and nutrients through an IV.

Rarely, labyrinthitis may be due to a break in the membranes between the middle and inner ear. Surgery to repair the break may be required. If a tumor is causing the condition, surgery may also be needed.

Prevention

To reduce your risk of getting labyrinthitis:

Seek prompt treatment for any ear problems or infection.
Get medical advice on treating respiratory infections.
Avoid head injury by wearing seat belts and safety helmets.
Ask your doctor about side effects of any medication you are taking.
Avoid alcohol.
Take steps to prevent blood vessel disease or stroke. These include:
- Eat a low fat, low cholesterol diet.
- Don’t smoke.
- If you have high blood pressure, get it treated.
- If you have diabetes, work closely with your doctor to keep it under good control.
- With your doctor's approval, exercise regularly.

National Library of Medicine

http://www.nlm.nih.gov/

Vestibular Disorders Association

http://www.vestibular.org/

Health Canada

http://www.hc-sc.gc.ca/

Healthy U

http://www.healthyalberta.com/

Dizziness - differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated December 16, 2011. Accessed December 28, 2012.

Inner ear infections. Vestibular Disorders Associations website. Available at: http://www.nlm.nih.gov/. Accessed December 28, 2012.

Labyrinthitis. American Association of Family Physicians Familydoctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/labyrinthitis.html. Accessed December 28, 2012.

Labyrinthitis. Johns Hopkins Medical Center website. Available at: http://www.nlm.nih.gov/. Accessed December 28, 2012.

12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.

Last reviewed November 2012 by Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.