Labyrinthitis and vestibular neuritis are most commonly caused by a viral infection that affects the inner ear. These conditions typically cause vertigo (intense dizziness, often with vomiting). In most cases the symptoms gradually ease and go within a few weeks as the infection clears. Medication may help to ease symptoms. There are some less common causes which may have a different outlook and treatment.
What is the labyrinth and what does it do?
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. The semicircular canals are connected to a larger fluid-filled chamber called the vestibule which in turn is connected to the fluid-filled canal in the cochlea.What is vestibular neuritis and labyrinthitis?
These names used to be used interchangeably but are now used more specifically:- Vestibular neuritis (sometimes called vestibular neuronitis) 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.
What are the causes of labyrinthitis and vestibular neuritis?
Viral infection
The common cause of labyrinthitis and vestibular neuritis is a viral infection. They are called viral labyrinthitis and viral vestibular neuritis. There are various viruses that can cause these problems. The infection may occur at the same time as, or just after, you have a common viral illness such as a sore throat, glandular fever, flu, or a cold. The cold sore virus may also be a cause. Sometimes you may not be aware of any other viral infection and just develop symptoms of labyrinthitis or vestibular neuritis.Other causes
Other causes are uncommon. Strictly speaking, 'itis' at the end of a word means inflammation. However, the terms labyrinthitis and vestibular neuritis are sometimes used for any damage or inflammation to the labyrinth or vestibular nerve, which can be due to various causes. For example, the following conditions will all have other symptoms and problems but may also cause labyrinthitis or vestibular neuritis as a complication:- Infection with a germ (bacterium) in the middle ear. Most ear infections do not spread into the inner ear but a labyrinthitis or vestibular neuritis is an uncommon complication.
- Meningitis. The infection may spread from the brain to to the inner ear.
- A blockage of the blood circulation to part of the brain.
- Injury to the ear.
- Allergies.
- Tumours.
- An uncommon side-effect of some medicines.
What are the symptoms of labyrinthitis and vestibular neuritis?
Vertigo
The main symptom is vertigo. Vertigo is dizziness with a spinning sensation. If you have vertigo you feel as if the world is spinning around you and you feel very unsteady. Often you will also feel sick or vomit. Typically, if a viral infection is the cause (the common situation), you develop vertigo quite quickly. Vertigo occurs because the inflamed or damaged labyrinth or vestibular nerve sends conflicting signals to the brain compared with the normal ear. The brain becomes very confused about your head posture and reacts to cause vertigo.The vertigo can become intense and constant for the first few days and you simply have to lie down until the symptoms ease. The vertigo may be less intense if you lie down and is often made worse by sitting up, moving your head, or moving around. In milder cases the vertigo is less intense but you feel unsteady when moving or walking around.Other symptoms
You may also have:- 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. You may not notice this but a doctor will look for it as it is often present. (Labyrinthitis and vestibular neuritis are one cause of nystagmus. There are other causes.)
- Other symptoms of a viral infection such as a sore throat, flu symptoms or a cold.
- Pain in an ear. However, this is not normally a feature of a viral labyrinthitis or viral vestibular neuritis. If you have ear pain it may indicate that you have an infection with a germ (bacterium) in your middle ear that has spread to the inner ear.
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