Labyrinthitis

Definition

Labyrinthitis is an ear disorder characterized by inflammation (irritation and swelling with presence of extra immune cells) of the canals of the inner ear (semicircular canals, labyrinth), which causes dizziness.

Causes, incidence, and risk factors

The cause of labyrinthitis is unknown, but because it commonly occurs following otitis media (ear infection) or an upper respiratory infection (URI), it is thought to be a consequence of viral or bacterial infection. It may also follow allergy, cholesteatoma, or the ingestion of certain drugs that are toxic to the inner ear.

The semicircular canals of the inner ear (labyrinth) become inflamed. This disrupts their function, including the regulation of balance. Risk factors include the following:

• recent viral illness, respiratory infection, or ear infection
• use of prescription or nonprescription drugs (especially aspirin)
• stress
• fatigue
• a history of allergy, smoking, or heavy alcohol consumption.

Symptoms

• dizziness
• abnormal sensation of movement (vertigo)
  • may be accompanied by nausea and vomiting
  • may be severe
  • may be continuous for up to a week at a time
  • severe episodes may be followed by transient episodes for several weeks
• loss of balance, especially falling toward the affected side
• hearing loss in the affected ear
• ringing or other noises in the ears (tinnitus)
• involuntary eye movements (nystagmus)

Signs and tests

An ear examination may not reveal any changes.

Differentiation from other causes of dizziness or vertigo may include:

• head CT scan or MRI scan
• hearing testing (audiology/audiometry)
• caloric stimulation (tests reflexes of the eye)
• electronystagmography
• EEG, evoked auditory potential studies

Treatment

Labyrinthitis usually runs its course over a few weeks. However, symptoms may need treatment. Your doctor may prescribe an antibiotic to treat the infection. Medications that may reduce symptoms include the following:

• antihistamines
• anticholinergics
• sedative-hypnotics
• anti-emetics (antinausea medications)
• benzodiazepines

To prevent worsening of symptoms during episodes of labyrinthitis, try the following:

• Keep still and rest during attacks.
• Gradually resume activity.
• Avoid sudden position changes.
• Do not try to read during attacks.
• Avoid bright lights.

Assistance with walking may be needed during attacks. Avoid hazardous activities such as driving, operating heavy machinery, and climbing until one week after symptoms have disappeared.

Expectations (prognosis)

Recovery is usually spontaneous and hearing usually returns to normal.

Complications

• injury to self or others during attacks of vertigo
• permanent hearing loss in the affected ear (rare)
• spread of inflammation to other ear areas or to the brain (rare)

Calling your health care provider

Call your health care provider if dizziness, vertigo, loss of balance, or other symptoms of labyrinthitis are present. Also call if hearing loss occurs.

Urgent or emergency symptoms include convulsions, fainting, persistent vomiting, or vertigo accompanied by fever of more than 101 degrees Fahrenheit.

Prevention

Prompt treatment of respiratory infections and ear infections may help prevent labyrinthitis.

Illustrations

Ear anatomy

Page Content:

Bacterial labyrinthitis; Serous labyrinthitis