The labyrinth is a section of the inner ear that contains the organs of balance (the semicircular canals and otolithic organs). If this part of the ear becomes swollen and inflamed you may develop vestibular neuritis or labyrinthitis. The inflammation may cause sudden vertigo because nerves from the labyrinth start to send incorrect signals to the brain. These signals are telling your body it is moving, but your other senses (such as vision) do not detect the same movement. The confusion in signals can make you feel that the room is spinning or that you have lost your balance, otherwise known as vertigo. Vertigo makes you feel like you are spinning or whirling. This can make it hard for you to walk. Cases in which only the balance function is affected is known as vestibular neuritis. Labyrinthitis occurs when there is hearing loss that accompanies the vertigo.
These problems are typically thought to be related to a viral infection - although this has not been proven. Some cases of vestibular neuritis/labyrinthitis can be brought on by fluid or infection in the middle ear (behind the eardrum). Your doctor will try to differentiate between the two. Hearing tests and imaging studies such as a CT scan or MRI may be ordered.
Tests to make an accurate diagnosis may include hearing tests and a CT or MRI scan. Your doctor will also check your eyes, which may be flickering uncontrollably. When a patient with vestibular neuritis or labyrinthitis is seen early these eye movement may be observed.
In some instances, vestibular neuritis/labyrinthitis is not obvious to detect during an ear exam, so a complete physical exam, including a neurological evaluation, should be performed. Symptoms of vestibular neuritis/labyrinthitis can mimic those of other conditions, so your doctor may order tests to rule them out. Some conditions that mimic vestibular neuritis/labyrinthitis include Meniere's disease (an inner ear disorder), migraine, small stroke, and brain tumor.
In rare instances, if the cause is a bacterial infection, your doctor will give you antibiotics, but most cases are caused by viral infections, which cannot be cured with antibiotics. Initial treatment may involve steroid medicine in attempt to shorten the duration and severity of symptoms. Medication for the dizziness and nausea can also be used. In some cases where imbalance persists for a long period of time, a course of vestibular therapy (balance therapy) may help resolve the imbalance more rapidly.
In addition to taking medications, there are multiple techniques you can use to relieve vertigo symptoms. Balance exercises consisting of simple head movements and keeping your balance while standing and sitting can help reduce symptoms of vertigo. Vertigo usually gets better as your body adjusts to what is happening (compensation). Medicines like antihistamines can help your other symptoms, but they may make it take longer for vertigo to go away for good. If your vertigo persists for a long time, physical and occupational therapists can teach you certain exercises that will help improve your balance. In most cases, vestibular neuritis/labyrinthitis will improve with time. This can take weeks to months.
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