Labyrinthitis

What is labyrinthitis?

Labyrinthitis is an inner ear infection characterized by inflammation of the labyrinth. The labyrinth is the inner ear system responsible for your hearing and sense of balance. When your labyrinth or one of the nerves inside your labyrinth is inflamed or irritated, hearing and balance can be affected. This is because your brain tries to make sense of mismatched information between your healthy labyrinth or nerve and your infected one.

Vestibular neuritis vs. labyrinthitis: What’s the difference?

Labyrinthitis is closely related to vestibular neuritis, another inner ear condition. Labyrinthitis refers to swelling of both branches of the vestibulocochlear nerve (the vestibular and cochlear portions), or inner ear (labyrinth), which affect balance and hearing. Vestibular neuritis refers to swelling of one branch of the vestibulocochlear nerve (the vestibular portion), which affects balance.

Who does labyrinthitis affect?

While labyrinthitis can affect people of all ages, the condition is most common in adults between the ages of 30 and 60. People assigned female at birth (AFAB) are twice as likely as people assigned male at birth (AMAB) to develop labyrinthitis.

What is the difference between vertigo and labyrinthitis?

Labyrinthitis is inflammation of the inner ear labyrinth. Vertigo, a common symptom of labyrinthitis, causes a person to feel as though their surroundings are spinning.

Is labyrinthitis dangerous?

Labyrinthitis is usually not dangerous unless it goes untreated. Without prompt and proper care, labyrinthitis can lead to hearing loss, increased risk of falling and permanent damage to your inner ear.

Permanent hearing loss is a common side effect in children who develop labyrinthitis as a complication of the brain infection meningitis. In cases like this, hearing may be restored with a cochlear implant.

What are the symptoms of labyrinthitis?

People with labyrinthitis may experience a sudden onset of symptoms, including:

• Loss of balance.
• Dizziness.
• Vertigo.
• Nausea and vomiting.
• Blurry vision.
• Tinnitus (ringing in the ears).
• Difficulty concentrating.
• Hearing loss.
• Nystagmus (involuntary eye movements).

What causes labyrinthitis?

In most cases, labyrinthitis is caused by a virus, though it can sometimes be caused by bacteria. The most common causes include:

• Bronchitis or other respiratory illnesses.
• Viral infections of the inner ear.
• Herpes viruses, including the Epstein-Barr virus.
• Stomach viruses.
• Bacterial infections.

Labyrinthitis can also be caused by measles, mumps, rubella, polio and hepatitis. In rare instances, labyrinthitis may be caused by a head injury or bacterial meningitis.

What can trigger labyrinthitis?

Having a cold or flu can trigger labyrinthitis. You also have a higher risk of developing labyrinthitis if you:

• Smoke.
• Are under a lot of stress.
• Drink a lot of alcohol.
• Are chronically tired.
• Have a history of allergies.

Certain drugs — such as anti-depressants, anti-inflammatories and some medications for diabetes — can also trigger labyrinthitis in some individuals.

Is labyrinthitis contagious?

No. Labyrinthitis itself isn’t contagious. However, if you catch the common cold or a flu from someone else, it could trigger labyrinthitis.

How is labyrinthitis diagnosed?

Your healthcare provider will perform a physical examination and ask you about your symptoms and medical history. They may also order tests to assess your hearing, balance and other nervous system functions.

What tests will be done to diagnose labyrinthitis?

There are several other conditions that have the same symptoms as labyrinthitis, so your healthcare provider will need to rule them out. They may do this by running certain tests, including:

• Magnetic resonance imaging (MRI). This test uses radio waves and powerful magnets to capture detailed images inside your body. Your provider may use MRI to rule out stroke.
• Electrocardiogram (EKG). This test records the electrical activity of your heart. EKG may be used to rule out cardiovascular problems.
• Vestibular Test Battery. This battery of tests is designed to evaluate the function of the balance portion of your labyrinth/vestibulocochlear nerve. This test uses electrodes to check your eye movements. Your provider may use ENG to evaluate the problem in your vestibular system and determine the cause of your symptoms.

How is labyrinthitis treated?

Labyrinthitis treatment depends on the root cause of your condition. For example, if your labyrinthitis is due to a virus, your healthcare provider will likely prescribe antiviral medications. If bacteria is the culprit, then antibiotics will be given. Additionally, corticosteroids may be recommended to reduce nerve inflammation, and medications to control dizziness and nausea (such as diphenhydramine or fexofenadine) may be prescribed on a short-term basis.

What if my symptoms don’t go away with medication?

If you’re still having labyrinthitis symptoms after a few weeks, vestibular rehabilitation exercises may be necessary to resolve your issues. This type of physical therapy can retrain your brain and help you adjust to the vestibular imbalance.

What is the fastest way to cure labyrinthitis?

Labyrinthitis symptoms and their response to treatment can vary from person to person. What works well for one individual may not work as well for you. However, in many cases, antihistamines — such as dimenhydrinate, diphenhydramine or meclizine — can quickly ease uncomfortable symptoms.

What home remedies can I try?

You can also try a number of home remedies to reduce discomfort, including:

• Apply a warm compress over your ear.
• Gargle with warm saltwater to help clear your eustachian tube (a small passage that connects your throat and middle ear).
• Avoid smoking.
• Limit alcohol intake.
• Try stress management techniques, such as mindfulness or meditation.

How can I reduce my risk for labyrinthitis?

Because labyrinthitis is usually an underlying symptom of other conditions, the best way to avoid it is to wash your hands regularly and take proper precautions during cold and flu season.

How long does labyrinthitis last?

It varies for each person. In most cases, labyrinthitis symptoms ease up within a few days. It could take up to six weeks or longer for your balance to return to normal.

When can I go back to work or school?

If you’ve been diagnosed with labyrinthitis, you’ll need to recover at home until your symptoms have diminished. This timeline varies dramatically for each person. If you're experiencing vertigo or balance issues, ask your healthcare provider when it’s safe to go back to work or school. Many people benefit from participation in a specialized physical therapy program called vestibular rehabilitation to reduce symptoms of dizziness, vertigo and imbalance.

When should I see my healthcare provider?

If you develop any symptoms of labyrinthitis, such as vertigo, nausea or balance problems, you should call your healthcare provider right away. They can help determine the cause of your symptoms and design a personalized treatment plan.

A note from Cleveland Clinic

Labyrinthitis can lead to many unpleasant side effects that can diminish your quality of life. Should you develop symptoms, don’t wait until they worsen. Timely treatment can reduce the likelihood that your inner ear issues will turn into long-term problems.