Why does labyrinthitis keep coming back

Generally caused by a viral infection, they cause vertigo usually experienced as a spinning sensation , dizziness, imbalance, unsteadiness and sometimes problems with vision or hearing. In a healthy balance system, the brain combines messages sent by the balance control systems in both ears, but if one side is affected, the messages from that side are distorted, causing symptoms of dizziness and vertigo. Symptoms of labyrinthitis and vestibular neuritis Symptoms of vestibular neuritis include a sudden onset of a constant, intense spinning sensation that is usually disabling and requires bed rest.

It is often also linked with nausea, vomiting, unsteadiness, imbalance, difficulty with vision and the inability to concentrate. While neuritis affects only the inner ear balance apparatus, labyrinthitis also affects the inner ear hearing apparatus and the cochlear nerve, which transmits hearing information.

This means that labyrinthitis may cause hearing loss or ringing in the ears tinnitus. Bacterial labyrinthitis can start from an untreated middle ear infection, or in rare cases, as a result of meningitis.

The infections that cause vestibular neuritis and labyrinthitis may resolve without treatment within a few weeks. However, if the inner ear is permanently damaged by the infection and the brain does not adequately compensate, symptoms can develop into chronic dizziness, fatigue, disorientation, as well as tinnitus and hearing loss if labyrinthitis is the cause.

Diagnosis of labyrinthitis and vestibular neuritis Your condition can be diagnosed based on your medical history, answers to questions about the initial onset of the symptoms and your current symptoms, a physical examination and possibly the results of tests carried out by an audiologist, including a hearing test.

Treatment for labyrinthitis and vestibular neuritis The treatment of labyrinthitis depends on the likely cause. If symptoms persist, a specialist physiotherapist can use vestibular rehabilitation exercises to retrain the brain to interpret the distorted balance messages being transmitted from the damaged inner ear. Vestibular neuritis can be treated with corticosteroids a type of anti-inflammatory medication in the early stages, and, if necessary, with medication to reduce nausea and vertigo.

Self-care at home for labyrinthitis and vestibular neuritis If your treatment involves vestibular rehabilitation exercises, it is important to continue the exercises at home for as long as you are advised to by your specialist or balance physiotherapist. Viral infections of the inner ear are more common than bacterial infections, but less is known about them.

An inner ear viral infection may be the result of a systemic viral illness one affecting the rest of the body, such as infectious mononucleosis or measles ; or, the infection may be confined to the labyrinth or the vestibulo-cochlear nerve.

Usually, only one ear is affected. Some of the viruses that have been associated with vestibular neuritis or labyrinthitis include herpes viruses such as the ones that cause cold sores or chicken pox and shingles , influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr. Other viruses may be involved that are as yet unidentified because of difficulties in sampling the labyrinth without destroying it.

Because the inner ear infection is usually caused by a virus, it can run its course and then go dormant in the nerve only to flare up again at any time.

There is currently no way to predict whether or not it will come back. Symptoms of viral neuritis can be mild or severe, ranging from subtle dizziness to a violent spinning sensation vertigo. They can also include nausea, vomiting, unsteadiness and imbalance, difficulty with vision, and impaired concentration.

Sometimes the symptoms can be so severe that they affect the ability to stand up or walk. Onset of symptoms is usually very sudden, with severe dizziness developing abruptly during routine daily activities. In other cases, the symptoms are present upon awakening in the morning. The sudden onset of such symptoms can be very frightening; many people go to the emergency room or visit their physician on the same day. After a period of gradual recovery that may last several weeks, some people are completely free of symptoms.

Others have chronic dizziness if the virus has damaged the vestibular nerve. Without necessarily understanding the reason, they may observe that everyday activities are fatiguing or uncomfortable, such as walking around in a store, using a computer, being in a crowd, standing in the shower with their eyes closed, or turning their head to converse with another person at the dinner table.

Therefore, a process of elimination is often necessary to diagnose the condition. Because the symptoms of an inner ear virus often mimic other medical problems, a thorough examination is necessary to rule out other causes of dizziness, such as stroke, head injury, cardiovascular disease, allergies, side effects of prescription or nonprescription drugs including alcohol, tobacco, caffeine, and many illegal drugs , neurological disorders, and anxiety.

When other illnesses have been ruled out and the symptoms have been attributed to vestibular neuritis or labyrinthitis, medications are often prescribed to control nausea and to suppress dizziness during the acute phase.

Other medications that may be prescribed are steroids e. If nausea has been severe enough to cause excessive dehydration, intravenous fluids may be given. If treated promptly, many inner ear infections cause no permanent damage. In some cases, however, permanent loss of hearing can result, ranging from barely detectable to total.

Permanent damage to the vestibular system can also occur. Positional dizziness or BPPV Benign Paroxysmal Positional Vertigo can also be a secondary type of dizziness that develops from neuritis or labyrinthitis and may recur on its own chronically. Labyrinthitis may also cause endolymphatic hydrops abnormal fluctuations in the inner ear fluid called endolymph to develop several years later. If symptoms persist, further testing may be appropriate to help determine whether a different vestibular disorder is in fact the correct diagnosis, as well as to identify the specific location of the problem within the vestibular system.

These additional tests will usually include an audiogram hearing test ; and electronystagmography ENG or videonystagmography VNG , which may include a caloric test to measure any differences between the function of the two sides. Vestibular evoked myogenic potentials VEMP may also be suggested to detect damage in a particular portion of the vestibular nerve.

Physicians and audiologists will review test results to determine whether permanent damage to hearing has occurred and whether hearing aids may be useful. They may also consider treatment for tinnitus if it is present. Usually, the brain can adapt to the altered signals resulting from labyrinthitis or neuritis in a process known as compensation.

Vestibular rehabilitation exercises facilitate this compensation. In order to develop effective retraining exercises, a physical therapist will assess how well the legs are sensing balance that is, providing proprioceptive information , how well the sense of vision is used for orientation, and how well the inner ear functions in maintaining balance. Access myPennMedicine For Patients and Visitors. Patient Information. Conditions Treated A-Z. Definition Labyrinthitis is irritation and swelling of the inner ear.

Alternative Names Bacterial labyrinthitis; Serous labyrinthitis; Neuronitis - vestibular; Vestibular neuronitis; Viral neurolabyrinthitis; Vestibular neuritis; Labyrinthitis - vertigo: Labyrinthitis - dizziness; Labyrinthitis - vertigo; Labyrinthitis - hearing loss Causes Labyrinthitis is usually caused by a virus and sometimes by bacteria.

These factors raise your risk for labyrinthitis: Drinking large amounts of alcohol Fatigue History of allergies Recent viral illness, respiratory infection, or ear infection Smoking Stress Using certain prescription or nonprescription medicines such as aspirin Symptoms Symptoms may include any of the following: Feeling like you are spinning, even when you are still vertigo.

Your eyes moving on their own, making it hard to focus them. Hearing loss in one ear. Loss of balance -- you may fall toward one side. Nausea and vomiting. Ringing or other noises in your ears tinnitus. Exams and Tests Your health care provider may give you a physical exam. Tests can rule out other causes of your symptoms. These may include: EEG measures the electrical activity of the brain Electronystagmography, and warming and cooling the inner ear with air or water to test eye reflexes caloric stimulation Head CT scan Hearing test MRI of the head Treatment Labyrinthitis usually goes away within a few weeks.

Medicines that may help include: Antihistamines Medicines to control nausea and vomiting, such as prochlorperazine Medicines to relieve dizziness, such as meclizine or scopolamine Sedatives, such as diazepam Valium Corticosteroids Antiviral medicines If you have severe vomiting, you may be admitted to the hospital.

Doing these things can help you manage vertigo: Stay still and rest. Avoid sudden movements or position changes. Rest during severe episodes.

Slowly resume activity. You may need help walking when you lose your balance during attacks. Avoid bright lights, TV, and reading during attacks. Ask your provider about balance therapy.