vertigo

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Labyrinthitis – so what is Labyrinthitis?

Labyrinthitis

Labyrinthitis

Labyrinthitis is an inner ear infection.

It causes a delicate structure deep inside your ear called the labyrinth to become inflamed, which affects your hearing and balance.

 

Symptoms of labyrinthitis

The most common symptoms of labyrinthitis are:

feeling that you or your surroundings are moving or spinning (vertigo)

feeling or being sick

some hearing loss

These symptoms can vary in severity, with some people feeling that they can’t stand upright.

Other symptoms of labyrinthitis may include:

mild headaches

ringing or humming in your ear(s) (tinnitus)

fluid or pus leaking out of your ear(s)

ear pain

changes in vision, such as blurred vision or double vision

The symptoms of labyrinthitis can be quite severe during the first week, but usually get better after a few weeks.

In some cases the symptoms can last longer and have a significant impact on your quality of life and ability to carry out everyday tasks.

When to get medical help

If you have dizziness, vertigo, some hearing loss or any of the above symptoms and they don’t get better after a few days, or your symptoms are getting worse, see your GP or call NHS 111.

Symptoms of vertigo, nausea and sickness often improve gradually over a few days, although they can sometimes last for several weeks.

You may feel unsteady for a number of weeks or months. This usually improves over time and with treatment. Your hearing should return, although this may depend on the type of infection that caused the problem.

See your GP or call NHS 111 immediately if you have sudden hearing loss in one ear, with or without vertigo. It’s important the cause is investigated.

Diagnosing labyrinthitis

Labyrinthitis is diagnosed based on your symptoms, medical history and a physical examination.

Your GP may ask you to move your head or body, and your ears will be checked for signs of inflammation and infection.

You may also have some hearing tests, as labyrinthitis is more likely if you have hearing loss.

Your GP will also check your eyes. If they’re flickering uncontrollably, it’s usually a sign that your vestibular system, the body’s balancing system, isn’t working properly.

Treating labyrinthitis

The symptoms of labyrinthitis usually pass within a few weeks.

Treatment involves drinking plenty of fluid to avoid becoming dehydrated, bed rest, and medication to help you cope better with the symptoms.

Most cases of labyrinthitis are caused by a viral infection, in which case antibiotics won’t help. But you’ll be offered antibiotics if your doctor thinks your infection is bacterial.

Contact your GP if your symptoms don’t improve after three weeks. You may need to be referred to an ear, nose and throat (ENT) specialist.

A small number of people have symptoms that persist for several months or, in some cases, years. This requires a more intensive type of treatment called vestibular rehabilitation therapy (VRT). VRT is a specialised form of physiotherapy.

Read more about treating labyrinthitis.

What causes labyrinthitis?

Labyrinthitis is caused by an infection in the labyrinth. The labyrinth is the innermost part of the ear.

It contains the:

cochlea – a small spiral-shaped cavity that relays sounds to the brain and is responsible for hearing

vestibular system – a set of fluid-filled channels that contributes to your sense of balance

Labyrinthitis usually follows a viral infection, such as a cold or the flu. The infection can spread from the chest, nose, mouth and airways to the inner ear.

Infections that affect the rest of the body, such as measles, mumps or glandular fever, are a less common cause of viral labyrinthitis.

In rare cases, labyrinthitis can be caused by a bacterial infection. Bacterial labyrinthitis is more likely to affect young children and can be serious.

Bacteria can enter the labyrinth if the thin membranes separating your middle ear from your inner ear are broken. This can happen if you have a middle ear infection or an infection of the brain lining (meningitis).

Labyrinthitis can also develop in people who have an underlying autoimmune condition, where the immune system mistakenly attacks healthy tissue rather than fighting off infections.

Complications of labyrinthitis

Bacterial labyrinthitis carries a higher risk of causing permanent hearing loss, particularly in children who’ve developed it as a complication of meningitis.

As a result of this increased risk, a hearing test is recommended after having bacterial labyrinthitis.

Severe hearing loss after bacterial labyrinthitis can sometimes be treated with a cochlear implant. This is a small hearing device fitted under the skin behind your ear during surgery.

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Ménière’s disease – what are the signs and symptoms of Ménière’s disease?

Ménière's disease

Ménière’s disease

The symptoms of Ménière’s disease vary from person to person. They often begin as sudden attacks, lasting for a few hours. Some people may experience several attacks each week or they may be separated by weeks, months or even years.

See your GP if you experience any of the symptoms of Ménière’s disease, so they can try to identify the problem and refer you to a specialist, if necessary.

Main symptoms

The main symptoms of Ménière’s disease are:

vertigo – the sensation that you, or the environment around you, is moving or spinning

tinnitus – hearing sounds from inside your body, rather than from an outside source

hearing loss, with a particular difficulty hearing deep or low sounds

a sense of pressure or fullness deep inside the ear

These symptoms usually only affect one ear at first, but both ears often become affected over time.

Vertigo and tinnitus are described in more detail below.

Vertigo

Vertigo is one of the most common and noticeable symptoms of Ménière’s disease.

As well as a sensation of spinning, you may also experience additional symptoms during an attack of vertigo, such as dizziness, feeling or being sick, and problems with balance. You may have difficulty standing or walking. Occasionally, you may have “drop attacks”, where you suddenly fall to the ground.

During a severe attack, you may also experience sweating, diarrhoea and rapid or irregular heartbeats.

Tinnitus

Tinnitus is usually more noticeable when you’re tired or when it’s quiet, as there’s less background noise to distract you from sounds coming from inside your body.

Examples of sounds you may hear include buzzing, humming, grinding, hissing and whistling.

Stages of Ménière’s disease

Ménière’s disease is often divided into early, middle and late stages.

However, the progression of Ménière’s disease varies between individuals. You may not necessarily pass through each of these stages and the severity of the symptoms may also vary. In general, people experience more attacks during the first few years, and then as the attacks decrease in frequency over time, the hearing loss becomes progressively worse.

Some or all of the following symptoms may be experienced before an attack:

loss of balance

dizziness and lightheadedness

headache and increased ear pressure

increased hearing loss or tinnitus

sensitivity to sound

a feeling of uneasiness

If a person is aware of these warning symptoms, it can allow them to move to a safer or more comfortable situation before an attack.

The stages of Ménière’s disease are described in more detail below.

Early stage

The early stage of Ménière’s disease consists of sudden and unpredictable attacks of vertigo. These are usually accompanied by nausea, vomiting and dizziness. You may lose some hearing during the attack, and you may experience tinnitus at the same time. Your ear may also feel blocked and uncomfortable, with a sense of fullness. Some people may also experience sensitivity to sound.

Attacks of vertigo at this stage can last from 20 minutes to 24 hours, but usually last around two to three hours. Your hearing and the full sensation in your ear usually returns to normal between attacks.

Middle stage

The middle stage of Ménière’s disease consists of continuing attacks of vertigo, with the attacks becoming less severe for some people. However, tinnitus and hearing loss often become worse.

During the middle stage, you may experience some periods of remission (where your symptoms go away), which can last for up to several months. Some people may still experience symptoms of tinnitus, sensitivity to sound or loss of balance between attacks of vertigo.

Late stage

During the late stage of Ménière’s disease, the episodes of vertigo occur far less frequently. There may be months or even several years between attacks or they may stop altogether. However, you may be left with balance problems, and you may be unsteady on your feet, particularly in the dark.

Hearing problems and tinnitus tend to become progressively worse during the late stage of Ménière’s disease.

Vertigo
Vertigo is the sensation that you or the environment around you is moving or spinning.

Tinnitus
Tinnitus is the medical name for the perception of noise in one ear, both ears or in the head. The noise comes from inside the brain rather than an outside source.

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Vestibular Neuritis or Labyrinthitis – find out about the signs and symptoms here.

Vestibular Neuritis or Labyrinthitis is an inner ear infection. The infection causes the labyrinth (which is deep in the ear) to become inflamed. This can affect both your hearing and balance.

The labyrinth is the innermost part of your ear. It contains the cochlea (which) relays sounds to the brain and is responsible for hearing; and
the vestibular system which is a complex set of fluid-filled channels that contributes to your sense of balance.

The most common symptoms are dizziness, hearing loss (from mild to complete loss ) and vertigo which is when a person feels like if they or the objects around them are moving when they are not. In extreme cases people are unable to remain upright.

Other symptoms include:-

nausea
earache and headaches
pressure inside the ear
tinnitus
fluid leaking out of the ear

a high temperature (fever) of 38C (100.4F) or above
changes in vision, such as blurred vision or double vision
mild headaches

Vestibular Neuritis Infographic

From Visually.