Vestibular Neuritis or Labyrinthitis

Vestibular neuritis and labyrinthitis are viral or bacterial infections of the inner ear that inflame the inner ear or the nerves connecting the inner ear to the brain. With Labyrinthitis, the labyrinth (balance and hearing organs) may be affected and cause hearing loss or tinnitus, as well as vestibular symptoms such as vertigo, dizziness, or imbalance. With Vestibular Neuritis, normally only the vestibular system is affected, causing vestibular symptoms without hearing or tinnitus symptoms.

The onset of both conditions is typically abrupt and intense and may involve vertigo, imbalance, jumping vision due to eye movements, nausea and vomiting. The symptoms are usually severe and debilitating. Often people can’t walk during the initial episode. Typically the severe spinning symptoms dissipate over hours or days but long-term hearing or vestibular symptoms may linger.

What causes Vestibular Neuritis or Labyrinthitis?

Infections of the inner ear can be viral or bacterial.

Viral infections of the inner ear are more common. Some of the viruses that have been associated with vestibular neuritis or labyrinthitis include herpes viruses (such as the ones that cause cold sores or chickenpox and shingles), influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr.

Bacterial infections of the inner ear are less common. Bacteria can invade the hearing or balance systems or both.

What are symptoms of Vestibular Neuritis or Labyrinthitis?

Typically symptoms come on quickly and severely. Often the person is incapacitated and cannot walk. Symptoms such as severe spinning, vomiting, or instability can last hours or even days. However, varying degrees of hearing loss, tinnitus, or imbalance may linger. As the symptoms may mimic other serious conditions such as a stroke, immediate medical attention is advised.

How are Vestibular Neuritis or Labyrinthitis diagnosed?

As the symptoms may mimic something more serious such as a stroke, medical assessment is advised. Following medical investigation, audio-vestibular testing is often recommended to assess the cochlea (hearing organ) and vestibular system (balance organs and nerves). Test result patterns can indicate which balance sensors and which part/s of the vestibular nerve were affected. The estimated degree of recovery is also assessed to determine the type of vestibular rehabilitation needed.

What is the treatment for Vestibular Neuritis or Labyrinthitis?

Physicians may prescribe medications such as steroids to reduce inflammation. If permanent hearing or vestibular damage has occurred then hearing aids or vestibular rehabilitation may be recommended.