Labyrinthitis

Labyrinthitis is an inner ear infection. It causes the labyrinth inside your ear to become inflamed, affecting your hearing and balance.

Labyrinthitis usually starts suddenly and can be worrying. You should seek medical advice straight away.

What is the labyrinth?

The labyrinth is the innermost part of the ear. It contains 2 parts:

  • the cochlea – this sends sounds to the brain so you can hear
  • the vestibular system – a complex set of fluid-filled tubes that affect your balance

The labyrinth usually becomes inflamed either because of:

  • a viral infection, such as a cold or flu (viral labyrinthitis)
  • a bacterial infection, which is much less common (bacterial labyrinthitis)

Symptoms of labyrinthitis

The most common symptoms of labyrinthitis are:

  • vertigo (dizziness) – the sensation that you, or the environment around you, is moving
  • hearing loss (from mild to total loss of hearing)
  • a feeling of pressure inside your ear(s)
  • ringing or humming in your ear(s) (tinnitus)
  • feeling sick (nausea) or being sick
  • mild headaches

Certain things can make the dizziness worse, including:

  • colds or illness, or anything that makes you feel generally unwell
  • the dark
  • tiredness or jetlag
  • being on your period

Avoid driving, using tools and machinery, or working at heights if you’re feeling dizzy.

When to get medical advice

Speak to your GP practice if:

  • you have symptoms of labyrinthitis
  • your symptoms are getting worse

Diagnosing labyrinthitis

Your GP may:

  • ask about your symptoms
  • check your medical history
  • carry out a physical examination – you may be asked to move your head or body and they can check your ears for signs of inflammation and infection
  • test your hearing – labyrinthitis is more likely if you have hearing loss
  • check your eyes – if they’re flickering uncontrollably your balancing system may not be working properly

Treating labyrinthitis

You’ll usually have already seen your GP about labyrinthitis symptoms and may have started some treatment. There are things you can also do during this time to help manage your symptoms at home.

Things you can do to help your symptoms

Do

  • drink plenty of water to avoid becoming dehydrated – it’s best to drink little and often
  • lie still in a dark room if you feel very dizzy
  • lie in a comfortable position (on your side is often best)
  • try to get enough sleep – tiredness can make symptoms worse
  • try to reduce noise and anything that causes stress from your surroundings
  • avoid alcohol
  • avoid bright lights

Treatments from your doctor

If your symptoms are particularly severe, your GP may prescribe:

  • prochlorperazine – can help with dizziness and sickness
  • antiemetic – can help if you’re feeling sick and vomiting
  • corticosteroids – can help by reducing inflammation

Vestibular rehabilitation therapy (VRT)

A small number of people experience dizziness and vertigo for months or years. This is known as chronic labyrinthitis.

Chronic labyrinthitis requires a treatment called vestibular rehabilitation therapy (VRT). VRT is usually supervised by a physiotherapist. You can ask your GP to refer you or you can pay for private treatment. If you see a private physiotherapist, make sure they are fully qualified and a member of a recognised body. For example, the Chartered Society of Physiotherapy (CSP). Not all physiotherapists have training in VRT. You should tell them that you need this type of treatment before making an appointment.

Who can get labyrinthitis?

Most cases of viral labyrinthitis occur in adults aged 30 to 60 years old. Viral labyrinthitis is quite common in adults. Other types of ear infections are usually more common in children.

Bacterial labyrinthitis is much less common. Younger children under 2 years old are more vulnerable to developing bacterial labyrinthitis.

Vestibular neuronitis

Many people diagnosed with labyrinthitis only experience the balance symptoms without hearing loss.

This is known as vestibular neuronitis rather than labyrinthitis.

Both names are often used to describe the same diagnosis.

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