Labyrinthitis And Vertigo

Introduction

Definition of labyrinthitis and vertigo

Labyrinthitis means there is inflammation in your inner ear (the labyrinth). As the labyrinth is partially responsible for your sense of balance, you may develop vertigo (a spinning sensation and loss of balance) as a result. It is important to get checked by your doctor because bouts of dizziness and ear infections often have a treatable underlying cause.¹

Brief overview of the causes and symptoms

The most obvious symptoms of labyrinthitis and vertigo are painful, blocked ears due to an ear infection or injury, which are accompanied by poor balance and extreme dizziness.¹

You should seek urgent medical advice if you have labyrinthitis and/or vertigo and experience sudden and/or prolonged headaches, sickness or fever.²

You should seek emergency medical attention if you are suddenly struggling to see, hear or speak, or if you develop weakness or numbness in your arms or legs.²  

About labyrinthitis

Definition of labyrinthitis

Labyrinthitis is an infection of the labyrinth (the inner ear). The labyrinth consists of two functional structures:

• The cochlea for hearing
• The vestibule for balance¹

Causes of labyrinthitis

The labyrinth can become inflamed when you get a viral or bacterial infection.  

Viral infections which can lead to labyrinthitis include:

• Common cold
• Flu 
• Measles 
• Mumps 
• Glandular fever (also known as mononucleosis/’mono’)

Bacterial infections of the inner ear are less common, but are more serious as they can result from a meningitis infection, for example.  

If you have an autoimmune condition, your case of labyrinthitis may be caused by your immune system targeting the tissue in your inner ear, leading to inflammation.¹

Symptoms of labyrinthitis

Labyrinthitis causes a range of symptoms,¹ including:

• Imbalance 
• Hearing loss 
• Pain/pressure sensation in the ear
• Tinnitus 
• Weeping ears
• Nausea/vomiting 
• Fever
• Head tension
• Poor vision
• Vertigo

Diagnosis of labyrinthitis

To diagnose labyrinthitis, your doctor will:

• Take note of your symptoms 
• Consider any relevant medical history
• Perform some tests on your ears to check for inflammation or hearing loss
• Move your head around to check your balance 

Differentiating between viral labyrinthitis and bacterial labyrinthitis is also important. Most cases of labyrinthitis are caused by a less serious viral infection.  

You will be at higher risk of the more serious bacterial labyrinthitis if you are:

• A young child 
• Already diagnosed with another bacterial infection
• Feeling or being sick 
• Suddenly losing your hearing completely¹

Treatment of labyrinthitis

There are some things you can do at home to reduce the severity of your labyrinthitis symptoms.  

These include:

• Staying hydrated 
• Lying down to reduce dizziness 
• Reducing your exposure to symptom triggers like alcohol, bright lights and loud noises

Your doctor may also be able to prescribe medication depending on your symptoms, for example, anti-sickness tablets for nausea or antibiotics for a bacterial infection.  

Your doctor may also refer you to a physiotherapist for vestibular rehabilitation therapy (VRT). The physiotherapist will give you exercises that will help you cope with and eventually override the abnormal feeling of dizziness. 

These include exercises to improve your:

• Hand-eye coordination
• Steadiness
• Bodily movements¹

About vertigo

Definition of vertigo

Vertigo refers to the feeling of dizziness and the perception that your surroundings are spinning.

Types of vertigo

Benign paroxysmal positional vertigo (BPPV) attacks last for a few seconds or minutes, so this is generally considered a less serious type of vertigo.³ 

Vertigo attacks that last for a few hours to a few days can be extremely debilitating and so are considered a more serious form of vertigo. This may be due to Ménière's disease.

Causes of vertigo

Vertigo can be caused by various problems such as:

• Loose tissue floating in the inner ear vestibules (responsible for balance)
• Damage to the head 
• Vestibular neuronitis
• Labyrinthitis³

Symptoms of vertigo

Vertigo attacks can last anywhere from a few seconds to a few days depending on the type you have. Vertigo may also be a one-off symptom or a longer-lasting ailment depending on the underlying cause.

Common symptoms of vertigo include:

• Short-duration dizziness 
• Long-duration dizziness 
• Nausea/vomiting 
• Hearing loss
• Tinnitus 
• Pressure sensation in the ear³

Diagnosis of vertigo

Vertigo can be diagnosed by your GP through simple hearing and balance tests.  

You may also be referred to a specialist such as an ENT doctor or a neurologist for further scans and tests, but this may not be necessary if your GP is confident with your diagnosis.³

Treatment of vertigo

Vertigo is usually managed rather than simply treated. Whenever you have an attack, it is recommended that you sit or lie down to avoid falling over until the spinning sensation subsides.  You should also avoid driving and operating heavy machinery - make sure to notify the driving authority in your region, as well as your employer if you drive or operate heavy machinery for a living.  

To avoid having a vertigo attack, it is also recommended that you elevate your head while lying down and make slow, careful movements when changing the position of your body or head. You should also avoid tilting, over-stretching and hanging upside down for any amount of time. 

Your GP may recommend antihistamines and other medication to treat your symptoms.²

Labyrinthitis and vertigo

The relationship between labyrinthitis and vertigo

Vertigo is a symptom of labyrinthitis. If you have labyrinthitis, you may or may not experience the feeling of vertigo.¹

Symptoms of vertigo associated with labyrinthitis

If you have already been diagnosed with labyrinthitis, you may also receive a vertigo diagnosis if you experience a sensation of spinning and dizziness so severe that you lose balance or need to lie down.^1,2

Treatment of vertigo associated with labyrinthitis

To get rid of both your vertigo and labyrinthitis symptoms, your doctor may employ a combined treatment approach.

This may include treating your ear infection because your vertigo symptoms may disappear after your ear is no longer infected or inflamed. Alternatively, your doctor may simply advise you to manage your specific symptoms with medication, physical therapy or lifestyle changes.¹

Benign paroxysmal positional vertigo (BPPV)

Definition of BPPV

Benign paroxysmal positional vertigo (BPPV) is one of the most common forms of vertigo. It is considered mild, as attacks are short-lived, but it can be dangerous if it increases your risk of falls.⁴

Causes of BPPV

A BPPV attack is usually triggered by sudden changes in the position of your head, for instance, when looking up, down or side to side. Lying down and tossing in bed may also trigger symptoms of BPPV.⁴

Symptoms of BPPV

BPPV may make you feel like you or the environment around you is spinning. You may also become imbalanced or nauseous/sick as a result. These symptoms usually come and go, only lasting for a short period of time.⁴

Diagnosis of BPPV

BPPV can either be diagnosed by:

• A physical examination performed by your doctor, which may include checking your eyes for abnormal movement or tilting your head to test for signs of dizziness
• A medical imaging procedure, such as an MRI scan⁵

Treatment for BPPV

BPPV may improve without any treatment. However, your doctor may recommend treatment options such as:

• Canalith repositioning - a treatment where your doctor gradually moves your head into different positions to shift tiny balance-affecting crystals from your ear canals 
• Canal plugging surgery to ‘plug’ the inner ear and reduce the feeling of imbalance and dizziness⁵

Summary

Getting an inner ear infection can be painful and can lead to other conditions, such as vertigo. Dizziness and spinning are unpleasant symptoms, especially when they occur suddenly and affect you often. 

Managing labyrinthitis and vertigo is also not always easy - some treatments may work better for others and symptoms can return even after successful treatment. Don’t hesitate to reach out to a healthcare professional if you are struggling with any of these symptoms as they can suggest how to treat and manage your symptoms. These suggestions could prove to be successful on an individual, trial-and-error basis.