What is Labyrinthitis

Labyrinthitis is an inner ear infection. The inner ear is a system of tubes and canals (labyrinth) that are filled with fluid. The inner ear also contains nerve cells that send hearing and balance signals to the brain.

When tiny germs (microorganisms) get inside the labyrinth, they harm the cells that send messages to the brain. This can cause changes in hearing and balance.

Labyrinthitis usually develops suddenly and goes away with treatment in a few weeks (acute labyrinthitis). If the infection damages parts of the labyrinth, some symptoms may last for a long time (chronic labyrinthitis).

What are the causes?

Labyrinthitis is most often caused by a virus, such as one that causes:

• Infectious mononucleosis, also called “mono.”
• Measles.
• The flu.
• Herpes.

Labyrinthitis can also be caused by bacteria that spread from an infection in the brain or the middle ear (suppurative labyrinthitis). In some cases, the bacteria may produce a poison (toxin) that gets inside the labyrinth (serous labyrinthitis).

What increases the risk?

You may be at greater risk for labyrinthitis if you:

• Recently had a mouth, nose, or throat infection (upper respiratory infection) or an ear infection.
• Drink a lot of alcohol.
• Smoke.
• Use certain drugs.
• Are not well-rested (are fatigued).
• Are experiencing a lot of stress.
• Have allergies.

What are the signs or symptoms?

Symptoms of labyrinthitis usually start suddenly. The symptoms may range from mild to severe, and may include:

• Dizziness.
• Hearing loss.
• A feeling that you or your surroundings are moving when they are not (vertigo).
• Ringing in your ear (tinnitus).
• Nausea and vomiting.
• Trouble focusing your eyes.

Symptoms of chronic labyrinthitis may include:

• Fatigue.
• Confusion.
• Hearing loss.
• Tinnitus.
• Poor balance.
• Vertigo after sudden head movements.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history. Your health care provider may ask about any dizziness or hearing loss you have and any recent upper respiratory infections.
• A physical exam that involves:
  • Checking your ears for infection.
  • Testing your balance.
  • Checking your eye movement.
• Hearing tests.
• Imaging tests, such as CT scan or MRI.
• Tests of your eye movements (electronystagmogram, ENG).

How is this treated?

Treatment depends on the cause. If your condition is caused by bacteria, you may need antibiotic medicine. If it is caused by a virus, it may get better on its own.

Regardless of the cause, you may be treated with:

• Medicines to:
  • Stop dizziness.
  • Relieve nausea.
  • Reduce inflammation.
  • Speed up your recovery.
• Rest. You may be asked to limit your activities until dizziness goes away.
• IV fluids. These may be given at a hospital. You may need IV fluids if you have severe nausea and vomiting.
• Physical therapy. A therapist can teach you exercises to help you adjust to feeling dizzy (vestibular rehabilitation exercises). You may need this if you have dizziness that does not go away.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it exactly as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Rest as much as possible.
• Limit your activity as directed. Ask your health care provider what activities are safe for you.
• Do not make sudden movements until any dizziness goes away.
• If physical therapy was prescribed, do exercises as directed.

General instructions

• Avoid loud noises and bright lights.
• Do not drive until your health care provider says that this is safe for you.
• Drink enough fluid to keep your urine pale yellow.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

• Symptoms that do not get better with medicine.
• Symptoms that last longer than two weeks.
• A fever.

Get help right away if you have:

• Nausea or vomiting that is severe or does not go away.
• Severe dizziness.
• Sudden hearing loss.

Summary

• Labyrinthitis is an infection of the inner ear. It can cause changes in hearing and balance.
• Symptoms usually start suddenly and include dizziness, hearing loss, and nausea and vomiting. You may also have ringing in your ear (tinnitus), trouble focusing your eyes, and a feeling that you or your surroundings are moving when they are not (vertigo).
• If the condition lasts more than a few weeks, symptoms may include fatigue, confusion, hearing loss, poor balance, tinnitus, and vertigo.
• Treatment depends on the cause. If your labyrinthitis is caused by bacteria, you may need antibiotic medicine. If your labyrinthitis is caused by a virus, it may get better on its own.
• Follow your health care provider’s instructions, including how to take medicines, what activities to avoid, and when to get medical help.