What are labyrinthitis and vestibular neuritis?
Labyrinthitis and vestibular neuritis are two conditions of the inner ear and 8th cranial nerve that can lead to balance and hearing problems. Vestibular neuritis affects the vestibular portion of the inner ear/nerve, while labyrinthitis affects the entire inner ear/nerve, including both the balance and hearing organs.
Labyrinthitis causes hearing loss and dizziness while vestibular neuritis only causes dizziness or vertigo. Vestibular neuritis is also sometimes referred to as vestibular neuronitis.
What causes labyrinthitis and vestibular neuritis?
Both conditions are caused by inflammation resulting from inner ear infections. These infections are usually viral but may be caused by bacteria. The conditions can affect both ears, but more commonly occur in only one.
Some common viral illnesses that can lead to labyrinthitis or neuritis include:
Bacterial inner ear infections occur less often than viral infections and are more common in young children. Young children are more susceptible to chronic middle ear infections caused by a buildup of bacteria behind the eardrum. If these infections are not treated, the bacteria can enter the surrounding bone or inner ear labyrinth, leading to an inner ear infection. Bacteria can also enter the inner ear as a result of bacterial meningitis.
Who gets labyrinthitis and vestibular neuritis?
People with a history of viral illnesses are more susceptible to recurring viral infections, as the virus can lie dormant in the nerves and flare up later. These people may also have recurring labyrinthitis or neuritis for the same reason.
While rare, bacterial labyrinthitis or neuritis tends to occur more frequently in young children with recurring middle ear infections, especially if these infections have not been properly treated.
What are the signs and symptoms of labyrinthitis and vestibular neuritis?
- Sudden severe dizziness or vertigo that lasts several days to a week
- Nausea and vomiting
- Ear pressure and/or pain
- Tinnitus (ringing in the ears)
- Decreased hearing in one or both ears (labyrinthitis only)
What tests are used to diagnose labyrinthitis and vestibular neuritis?
There is no single test for labyrinthitis or vestibular neuritis. Doctors from our Ear, Nose and Throat (ENT) Department and Audiology work together to provide comprehensive medical, hearing and vestibular testing to help diagnose the conditions.
An ENT doctor may recommend imaging tests such as an MRI or CT scan to rule out other problems that cause dizziness. Everyone suspected of having labyrinthitis or neuritis should have a hearing and vestibular evaluation, even if their symptoms improve. These conditions can permanently damage the inner ear and cause future balance problems.
If your child has recurring balance issues, it’s helpful to keep a journal with the following information to help us make a diagnosis:
- Time and length of episodes
- Events that may have triggered an episode
What can I expect from labyrinthitis and vestibular neuritis tests?
If your child is experiencing sudden symptoms, you should contact their pediatrician immediately to see if immediate medical attention is necessary. Your child’s doctor may refer you to an ENT physician.
Knowing if there is any effect on hearing is the best way to differentiate between labyrinthitis and vestibular neuritis. During your ENT appointment, an audiologist completes a hearing test. For children who have severe symptoms that make it hard to participate in testing, we do distortion product otoacoustic emissions (DPOAE) testing to look for cochlear hair cell damage.
If you are unable to schedule an urgent ENT appointment to address these concerns, ask your child’s doctor if you should take them to the nearest Children’s Colorado’s emergency department for medical assessment. You can also call the ENT Department at 720-777-8501 to get advice on whether to take your child to the emergency department.
How are labyrinthitis and vestibular neuritis treated?
If an infection is causing your child’s symptoms, we will prescribe antibiotic or antiviral medications. For labyrinthitis, corticosteroids may reduce inflammation and hopefully restore hearing. We may also recommend short-term use of medications to treat dizziness and nausea to reduce the symptoms of vertigo.
Sometimes the infection can result in permanent damage, but quick intervention is the best way to restore hearing and vestibular function.
Some children have balance problems even after dizziness goes away. We often recommend physical therapy to help strengthen balance and reduce the risk of falls.
Why choose us for treatment of labyrinthitis and vestibular neuritis?
The Pediatric Balance and Vestibular Disorders Clinic at Children’s Colorado specializes in conditions like labyrinthitis and vestibular neuritis in children. When children complain of imbalance or dizziness, it could be the result of many different conditions. Our dedicated clinic helps diagnose and treat the full range of conditions related to these signs and symptoms.
Children’s Colorado is the only center in the state that has an enclosed rotary chair to assess vestibular disorders in young children and children with developmental differences. Without this testing, it is difficult to completely rule out inner ear disorders in some children.
The Vestibular Disorder Association (VeDA) provides support to anyone affected by vestibular (inner ear and brain balance) disorders by providing information and community resources.
Contacting us and making an appointment
Talk to your child’s doctor about your concerns. We usually require a referral to both audiology and ENT by a physician or advanced practice provider for vestibular testing and diagnostic exams.
We also want to ensure that the symptoms your child is experiencing do not require urgent medical attention. You can discuss these symptoms with an ENT nurse and get advice by calling 720-777-8501.
The ENT nurse may recommend that your child be evaluated by an ENT doctor first, and then if appropriate, follow up with vestibular testing to gather more information. If a vestibular evaluation is recommended, a scheduler will contact you to set up an appointment and provide additional instructions on how to prepare for the evaluation.