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Vestibular neuritis and labyrinthitis are disorders resulting from an infection that inflames the inner ear or the nerves connecting the inner ear to the brain. The hearing function involves the cochlea, a snail-shaped tube filled with fluid and sensitive nerve endings that transmit sound signals to the brain. Signals travel from the labyrinth to the brain via the vestibulo-cochlear nerve (the eighth cranial nerve), which has two branches. The brain integrates balance signals sent through the vestibular nerve from the right ear and the left ear. Neuritis (inflammation of the nerve) affects the branch associated with balance, resulting in dizziness or vertigo but no change in hearing. Labyrinthitis (inflammation of the labyrinth) occurs when an infection affects both branches of the vestibulo-cochlear nerve, resulting in hearing changes as well as dizziness or vertigo. Inner ear infections that cause vestibular neuritis or labyrinthitis are usually viral rather than bacterial. In serous labyrinthitis, bacteria that have infected the middle ear or the bone surrounding the inner ear produce toxins that invade the inner ear via the oval or round windows and inflame the cochlea, the vestibular system, or both.
Less common is suppurative labyrinthitis, in which bacterial organisms themselves invade the labyrinth.
Viral infections of the inner ear are more common than bacterial infections, but less is known about them. Some of the viruses that have been associated with vestibular neuritis or labyrinthitis include herpes viruses (such as the ones that cause cold sores or chicken pox and shingles), influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr. Symptoms of viral neuritis can be mild or severe, ranging from subtle dizziness to a violent spinning sensation (vertigo).
Onset of symptoms is usually very sudden, with severe dizziness developing abruptly during routine daily activities.
After a period of gradual recovery that may last several weeks, some people are completely free of symptoms.
Many people with chronic neuritis or labyrinthitis have difficulty describing their symptoms, and often become frustrated because although they may look healthy, they don’t feel well. Some people find it difficult to work because of a persistent feeling of disorientation or “haziness,” as well as difficulty with concentration and thinking. When other illnesses have been ruled out and the symptoms have been attributed to vestibular neuritis or labyrinthitis, medications are often prescribed to control nausea and to suppress dizziness during the acute phase.
If symptoms persist, further testing may be appropriate to help determine whether a different vestibular disorder is in fact the correct diagnosis, as well as to identify the specific location of the problem within the vestibular system.
Physicians and audiologists will review test results to determine whether permanent damage to hearing has occurred and whether hearing aids may be useful. If symptoms of dizziness or imbalance are chronic and persist for several months, vestibular rehabilitation exercises (a form of physical therapy) may be suggested in order to evaluate and retrain the brain’s ability to adjust to the vestibular imbalance. In order to develop effective retraining exercises, a physical therapist will assess how well the legs are sensing balance (that is, providing proprioceptive information), how well the sense of vision is used for orientation, and how well the inner ear functions in maintaining balance. The exercises may provide relief immediately, but a noticeable difference may not occur for several weeks.
Visit VEDA's Resource Library to get more information about your vestibular disorder and download one of VEDA's many short publications.


Please help VEDA continue to provide resources that help vestibular patients cope and find help. Labyrinthitis is an inflammation of the bony labyrinth that impacts on the function of both the vestibular and auditory systems. Labyrinthitis- is most commonly caused by a viral infection that affects the inner ear. Migraine Associated Vertigo (Vestibular Migraine) -  Migraine is a complex condition involving the blood supply to parts of the brain and inner ear.
Labyrinthitis refers to an ear disorder characterized by irritation and inflammation (swelling) of the inner ear, the causes of which are several. This inflammation disrupts the transmission of sensory information from the ear to the brain.
Such inner ear infections are not the same as middle ear infections, which are the type of bacterial infections common in childhood affecting the area around the eardrum. Fluid and hair cells in the three loop-shaped semicircular canals and the sac-shaped utricle and saccule provide the brain with information about head movement. One branch (the cochlear nerve) transmits messages from the hearing organ, while the other (the vestibular nerve) transmits messages from the balance organs.
The term neuronitis (damage to the sensory neurons of the vestibular ganglion) is also used.
Although the symptoms of bacterial and viral infections may be similar, the treatments are very different, so proper diagnosis by a physician is essential. Serous labyrinthitis is most frequently a result of chronic, untreated middle ear infections (chronic otitis media) and is characterized by subtle or mild symptoms.
The infection originates either in the middle ear or in the cerebrospinal fluid, as a result of bacterial meningitis.
An inner ear viral infection may be the result of a systemic viral illness (one affecting the rest of the body, such as infectious mononucleosis or measles); or, the infection may be confined to the labyrinth or the vestibulo-cochlear nerve. Other viruses may be involved that are as yet unidentified because of difficulties in sampling the labyrinth without destroying it. Because the inner ear infection is usually caused by a virus, it can run its course and then go dormant in the nerve only to flare up again at any time. They can also include nausea, vomiting, unsteadiness and imbalance, difficulty with vision, and impaired concentration. Without necessarily understanding the reason, they may observe that everyday activities are fatiguing or uncomfortable, such as walking around in a store, using a computer, being in a crowd, standing in the shower with their eyes closed, or turning their head to converse with another person at the dinner table.
Examples include Benadryl (diphenhydramine), Antivert (meclizine), Phenergen (promethazine hydro¬chloride), Ativan (lorazepam), and Valium (diazepam). In some cases, however, permanent loss of hearing can result, ranging from barely detectable to total. These additional tests will usually include an audiogram (hearing test); and electronystagmography (ENG) or videonystagmography (VNG), which may include a caloric test to measure any differences between the function of the two sides. Usually, the brain can adapt to the altered signals resulting from labyrinthitis or neuritis in a process known as compensation. The evaluation may also detect any abnormalities in the person’s perceived center of gravity. Most of these exercises can be performed independently at home, although the therapist will continue to monitor and modify the exercises.


Many people find they must continue the exercises for years in order to maintain optimum inner ear function, while others can stop doing the exercises altogether without experiencing any further problems. Inflammation has a variety of potential causes, and therefore there are mulitple potential etiologies in the differential diagnosis of labyrinthitis. This condition typically causes vertigo (intense dizziness, often with vomiting).There are short term medications that can ease the sickness however these in our opinion should only be used for acute symptoms and not long term as this can slow down compensation.
Most people think of a migraine as a severe headache with feeling sick (nausea) and some visual disturbance.
It mostly occurs as a result of an ear infection, an upper respiratory infection, an allergy, cholesteatoma, or intake of certain drugs dangerous to the inner ear.
Bacteria can enter the inner ear through the cochlear aqueduct or internal auditory canal, or through a fistula (abnormal opening) in the horizontal semicircular canal.
The sudden onset of such symptoms can be very frightening; many people go to the emergency room or visit their physician on the same day. Because the symptoms of an inner ear virus often mimic other medical problems, a thorough examination is necessary to rule out other causes of dizziness, such as stroke, head injury, cardiovascular disease, allergies, side effects of prescription or nonprescription drugs (including alcohol, tobacco, caffeine, and many illegal drugs), neurological disorders, and anxiety. Vestibular evoked myogenic potentials (VEMP) may also be suggested to detect damage in a particular portion of the vestibular nerve.
As part of assessing the individual’s balancing strategies, a test called computerized dynamic posturography (CDP) is sometimes used. It is usually recommended that vestibular-suppressant medications be discontinued during this exercise therapy, because the drugs interfere with the ability of the brain to achieve compensation.
A key component of successful adaptation is a dedicated effort to keep moving, despite the symptoms of dizziness and imbalance.
Normally the virus clears within 12 weeks however if this persists you should contact your doctor and discuss about seeing an ENT specialist. In case of labyrinthitis, the parts of the inner side of the ear become swollen and irritated that disturbs its functionality, including the ability to balance you. If nausea has been severe enough to cause excessive dehydration, intravenous fluids may be given.
Positional dizziness or BPPV (Benign Paroxysmal Positional Vertigo) can also be a secondary type of dizziness that develops from neuritis or labyrinthitis and may recur on its own chronically. Sitting or lying with the head still, while more comfortable, can prolong or even prevent the process of adaptation. Often the balance system is affected resulting in a feeling of dizziness, spinning and imbalance.
Risk factors include excessive alcoholism, stress, fatigue, allergies, recent viral fever, respiratory or ear infection, smoking, and intake of certain non-prescribed drugs. Labyrinthitis may also cause endolymphatic hydrops (abnormal fluctuations in the inner ear fluid called endolymph) to develop several years later. Symptoms of labyrinthitis are abnormal sensation of movement, dizziness, nausea, vomiting, hearing loss in one ear, involuntary eye movements, and ringing in the ears.



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