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Labyrinthitis

IntroductionWake Forest Physical Therapy Balance and Vestibular

Labyrinthitis is an inflammation of the inner ear structure called the labyrinth.

Anatomy

There is a labyrinth in each of the inner ears, encased in thick bone near the base of the skull.  As the name implies, the labyrinth is a maze of interconnected fluid-filled channels and canals.  Half of the labyrinth, the cochlea, is shaped like a snail’s shell that sends information about sounds to the brain.  The other half has three semicircular canals connected to an open cavern or vestibule.  The vestibule portion of the labyrinth sends information to the brain regarding the position and movement of your head.  Any disturbance of the vestibule can lead to faulty information going to your brain.  Your eyes also send positioning information to your brain.  When information from the labyrinth and the eyes don’t match, the brain has trouble interpreting what is happening and this misinterpretation often leads to a sensation that you are spinning (vertigo) or a feeling that you are moving when in fact you are remaining still.

Causes

Many times, you cannot determine the cause of labyrinthitis.  Often, the condition follows a viral illness such as a cold or the flu.  Viruses, or your body’s immune response to them, may cause inflammation that result in labyrinthitis.  Other potential causes are trauma or injury to your head or ear, bacterial infections, allergies, a benign tumor of the middle ear, or certain medications taken in high doses.

Symptoms

The most common symptoms of labyrinthitis are vertigo, nausea, vomiting, loss of balance, headaches, tinnitus (ringing in your ears), or hearing loss.  These symptoms usually become worse by moving your head, sitting up, rolling over, or looking up.  Rarely, this condition may last all your life, as with Meniere’s disease.  This condition usually involves tinnitus and hearing loss with the vertigo.

Diagnosis

Your physician will need to do a complete physical and neurological exam to make a diagnosis of labyrinthitis.  An ear exam will not necessarily reveal any problems.  Usually, other tests are not needed to make this diagnosis; however, your doctor may choose to do diagnostic testing to rule out any other causes of your symptoms.

Balance TrainingTreatment

If symptoms of dizziness or imbalance are chronic and persist for several months, vestibular rehabilitation exercises may be suggested in order to evaluate and retrain the brain’s ability to adjust to the vestibular imbalance.  In order to develop effective retraining exercises, a physical therapist will assess how well the legs are sensing balance, how well the sense of vision is used for orientation, and how well the inner ear functions in maintaining balance.  The evaluation may also detect any abnormalities in the person’s perceived center of gravity.  After the evaluation, personalized vestibular rehabilitation exercises are developed.  The exercises may provide relief immediately, but a noticeable difference may not occur for several weeks.

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