Bacterial labyrinthitis

Definition

Labyrinthitis is an ear disorder that involves irritation and swelling of the inner ear.

Alternative Names

Causes

The cause of labyrinthitis is unknown. However, it commonly occurs after otitis media (ear infection) or an upper respiratory infection, so it is thought to be related to infection with a virus or bacteria. It may also follow allergy, cholesteatoma, or after taking certain drugs that are dangerous to the inner ear.

During labyrinthitis, the parts of the inner ear become irritated and inflamed. This interferes with their function, which includes the ability to keep your balance.

The following raise your risk for labyrinthitis:

• Recent viral illness, respiratory infection, or ear infection
• Use of certain prescription or nonprescription drugs (especially aspirin)
• Stress
• Fatigue
• History of allergies
• Smoking
• Drinking large amounts of alcohol

Symptoms

• Dizziness
• Abnormal sensation of movement (vertigo), possibly severe, with nausea and vomiting
• Loss of balance, especially falling toward the affected side
• Hearing loss in the affected ear
• Ringing or other noises in the ears (tinnitus)
• Involuntary eye movements (nystagmus)

Exams and Tests

An ear examination may not reveal any problems. Tests will be done to rule out other causes of dizziness or vertigo. These may include:

• Head CT scan
• MRI scan
• Hearing testing (audiology/audiometry)
• Caloric stimulation (tests reflexes of the eye)
• Electronystagmography
• EEG
• Evoked auditory potential studies

Treatment

Labyrinthitis usually goes away within a few weeks. However, symptoms may need treatment. Your doctor may prescribe an antibiotic to treat the infection. Medications that may reduce symptoms include the following:

• Antihistamines
• Anticholinergics
• Sedative-hypnotics
• Anti-emetics (antinausea medications)
• Benzodiazepines

To prevent worsening of symptoms during episodes of labyrinthitis, try the following:

• Keep still and rest during attacks.
• Gradually resume activity.
• Avoid sudden position changes.
• Do not try to read during attacks.
• Avoid bright lights.

You may need help walking during attacks. Avoid hazardous activities such as driving, operating heavy machinery, and climbing until 1 week after symptoms have disappeared.

Outlook (Prognosis)

Hearing usually returns to normal.

Possible Complications

• Injury to self or others during attacks of vertigo
• Permanent hearing loss (rare)
• Spread of inflammation to other ear areas or to the brain (rare)

When to Contact a Medical Professional

Call your health care provider if dizziness, vertigo, loss of balance, or other symptoms of labyrinthitis are present. Also call if hearing loss occurs.

Urgent or emergency symptoms include convulsions, fainting, persistent vomiting, or vertigo accompanied by fever of more than 101 degrees Fahrenheit.

Prevention

Prompt treatment of respiratory infections and ear infections may help prevent labyrinthitis.

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