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Mass Tort Update
Labyrinthitis
What is labyrinthitis?
Labyrinthitis means an inflammation of the inner ear structure called the labyrinth. Sometimes the term labyrinthitis refers to other causes of inner ear problems that have no inflammation because those problems produce similar symptoms. Inflammation of these structures, or labyrinthitis, can occur as a result of a viral or, more rarely, bacterial infection.
You have a labyrinth in each of your inner ears, encased in thick bone near the base of your skull. As the name implies, the labyrinth is a maze of interconnected fluid-filled channels and canals. Half of the labyrinth, the cochlea, is shaped like a snail’s shell. It sends information about sounds to the brain. The other half looks something like a gyroscope with 3 semicircular canals connected to an open cavern or vestibule. The vestibule portion of the labyrinth sends information to the brain regarding the position and movement of your head. Any disturbance of the vestibule can lead to faulty information going to your brain.
Your eyes also send positioning information to your brain. When information from the labyrinth and the eyes don’t match, the brain has trouble interpreting what is happening. This misinterpreting often leads to a sensation that you are spinning (vertigo) or a feeling that you are moving when in fact you are remaining still. Feelings of motion sickness (nausea and vomiting) often follow. Sometimes you will experience hearing loss or abnormal sounds such as a high- or low-pitched ringing (tinnitus).
Bacterial labyrinthitis may develop after a middle ear infection (otitis media) or an infection of the lining of the brain (meningitis) and is a more serious condition.
What causes labyrinthitis?
The cause of labyrinthitis is not clear. It is often triggered by an upper respiratory infection (such as the flu or a cold). Less often, labyrinthitis may develop after a middle ear infection (otitis media). Rarely, labyrinthitis is triggered by a bacterial infection.
What are the symptoms?
The main symptom of labyrinthitis is vertigo, a spinning or whirling sensation you feel although neither you nor your surroundings are moving. Vertigo results when there is a problem with your balance sensory systems, which include your vision, sensory nerves, inner ear, and skin pressure sensation, that are all interpreted by your brain.
People often use the terms vertigo and dizziness interchangeably, but they are different symptoms and may indicate different problems. Vertigo is a feeling that you or your surroundings are moving when there is no actual movement.
The motion is commonly described as a feeling of spinning or whirling but can also include sensations of falling or tilting. Nausea and vomiting often accompany more severe episodes of vertigo. It may be difficult to walk or stand, and you may lose your balance and fall.
Vertigo caused by labyrinthitis begins suddenly without warning and gradually goes away over a few days to weeks, although sudden head movement can trigger vertigo for a month or longer.
You may also develop a condition called nystagmus, which is involuntary or "jerking" eye movements.
Labyrinthitis may also cause temporary hearing loss, along with a roaring sound in the ears (tinnitus). Although rare, hearing loss triggered by a bacterial infection may be permanent.
How is labyrinthitis diagnosed?
Labyrinthitis is diagnosed with a medical history and a physical examination. If you have symptoms of vertigo (spinning or whirling sensation), your health professional will determine whether it is from inflammation of the labyrinth and, if so, whether you have recently had a viral or bacterial infection.
Your health professional may perform a Dix-Hallpike test, which can offer clues about the cause of vertigo. In particular, your health professional will look for signs of an ear infection, which can cause labyrinthitis.
If the cause of your vertigo is unclear, your health professional may want to do more tests. Such tests can help determine whether your vertigo is caused by problems in the inner ear or brain. Brain-related causes of vertigo (such as stroke, head injury, brain tumors, or multiple sclerosis) are less common.
Additional tests that may be done to rule out other causes of your vertigo include:
How is it treated?
Labyrinthitis usually goes away on its own within a few days to weeks. If labyrinthitis was triggered by a bacterial infection, antibiotics may be prescribed. Viral infections cannot be cured with antibiotics.
Additional treatment is intended to keep you comfortable until the labyrinthitis goes away. Medications called vestibular suppressants may be prescribed to reduce symptoms.
If a bacterial infection has injured your inner ear, you may continue to have symptoms of vertigo even after the infection has healed. Over time, your body should adjust to the confusing signals from the balance sensory systems that falsely tell your brain to detect motion that isn't occurring. The vertigo will eventually lessen or disappear completely. This process is called compensation. Remaining as active as possible speeds compensation. Unfortunately, medications may slow compensation and should only be taken for 1 to 2 weeks.
What To Think About
Be sure to take your medications exactly as prescribed, and do not stop taking them even if you feel better; otherwise, the infection may not go away.
Persistent vertigo may be caused by other conditions and should be evaluated by your health professional.
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