Labyrinthitis and Vestibular Neuritis (Acoustic Neuronitis)

Labyrinthitis is inflammation and dysfunction of the inner ear. Vestibular neuritis is inflammation and dysfunction of the vestibular nerve that leads from the inner ear to the brain.

The causes and symptoms of labyrinthitis and vestibular neuritis are similar.

The most common cause is a viral infection (viral labyrinthitis or viral vestibular neuritis). Other less common causes include bacterial infection of the middle ear; meningitis; ear injury; allergies; tumours and side effects of some drugs.

The main symptom is vertigo which is dizziness with a spinning sensation, resulting in unsteadiness. The vertigo is often of rapid onset, severe and improves on lying down but worsens on sitting up, moving the head or moving around. Other symptoms include mild hearing loss on the affected side and nystagmus (jerking or rotatory movements of the eyes). There may be symptoms of a virus infection, such as sore throat or a cold. Pain in the ear is not normally a feature of viral labyrinthitis or viral vestibular neuritis but may be associated with a bacterial infection of the middle ear.

Initial treatment involves rest and medication to treat vomiting and dizziness (for example prochlorperazine) and possibly oral steroids. If the symptoms persist, the person is likely to be referred to a consultant for further investigation and treatment.

Viral labyrinthitis or viral vestibular neuritis is usually self limiting and symptoms can last from a few days to several weeks. Typically the symptoms are severe for 2 to 3 weeks and then settle down over several days. There may be some slight unsteadiness for 2 to 3 months before symptoms completely resolve. In a small number of cases symptoms can persist for months or years. These are due either to persistent inflammation after the viral infection has cleared or to a more serious underlying cause.

Amended April 2008