Labyrinthitis is an inner ear infection. It causes a delicate structure deep inside your ear called the labyrinth to become inflamed, affecting your hearing and balance.
Symptoms of labyrinthitis include:
The symptoms may be quite severe in the first week but usually get better after a few weeks. However, some cases can have much longer-lasting symptoms. This can have a major impact on a person's quality of life and their ability to do everyday tasks.
The labyrinth is the innermost part of the ear. It contains two important parts:
Inflammation of the labyrinth can disrupt both your hearing and sense of balance, triggering the symptoms of labyrinthitis.
The labyrinth usually becomes inflamed either because of:
Read more about the causes of labyrinthitis.
In most cases, the symptoms of labyrinthitis pass within a few weeks. Treatment for labyrinthitis involves a combination of bed rest and medication to help you cope better with the symptoms. In some cases you may need additional medication to fight the underlying infection.
A small number of people have persistent symptoms that last for several months, or possibly years.
These people will require a more intensive type of treatment called vestibular rehabilitation therapy (VRT). This treatment attempts to "retrain" the brain to cope with the altered signals that come from the vestibular system.
Most cases of viral labyrinthitis occur in adults aged 30 to 60 years old.
Viral labyrinthitis is thought to be a relatively common ear condition among adults. Other types of ear infections are usually more widespread in children.
One study found that around one in six people who visited their doctor with symptoms of vertigo had labyrinthitis.
Bacterial labyrinthitis is much less common. Younger children under two years old are more vulnerable to developing bacterial labyrinthitis.
Bacterial labyrinthitis carries a higher risk of causing permanent hearing loss. It's estimated that one in three cases of acquired hearing loss are caused by bacterial labyrinthitis. Read more about complications of labyrinthitis.
The three most common symptoms of labyrinthitis are dizziness, hearing loss and vertigo – the sensation that you, or the environment around you, is moving.
These symptoms can range from mild to severe. For example, some people may only feel mildly dizzy and out of balance. Other people have reported that their symptoms of vertigo and loss of balance were so intense that they could no longer remain upright and were worried that they might have been having a stroke.
Hearing loss can affect one or both ears and can range from mild to total loss of hearing.
Other symptoms of labyrinthitis include:
There are a number of things that sometimes make dizziness worse, including:
Avoid driving, using tools and machinery or working at heights if you're feeling dizzy and unbalanced.
Read more information about how labyrinthitis is treated.
Labyrinthitis is caused by inflammation of part of the inner ear known as the labyrinth. This is caused by an infection.
The fluid-filled channels of the labyrinth are known as the vestibular system. All the channels are connected and are at different angles.
When you move your head, the fluid inside the channels of the labyrinth also moves. This tells your brain how far, fast and in what direction your head is moving, which allows your body to balance properly.
The vestibular system works in a similar way to a stereo, with your right ear sending one signal to your brain and your left ear sending another signal. If one ear becomes infected, these signals become out of sync and the mismatch between the two signals can confuse your brain. This triggers many of the symptoms associated with labyrinthitis, such as dizziness and loss of balance.
The labyrinth also contains a small, spiral-shaped cavity called the cochlea. The cochlea sends sound waves to the language processing areas of the brain. Inflammation in and around your cochlea can disrupt this function, leading to hearing loss.
Labyrinthitis can sometimes be caused by a bacterial infection. This is rarer than a viral infection and is likely to be more serious.
Bacteria can enter the labyrinth if the thin layers of tissue that separate your middle ear from your inner ear are broken. This can happen if you have a middle ear infection or an infection of the brain lining (meningitis). Bacteria can also get into your inner ear if you have had a head injury.
Your doctor will usually diagnose labyrinthitis based on your symptoms, your medical history and a physical examination.
Your doctor will also check your eyes. If they are flickering uncontrollably, it is usually a sign that your vestibular system (the body's balancing system) is not working properly.
There is no reliable test to determine whether labyrinthitis is caused by a viral or bacterial infection. This is because it is currently impossible to directly test for infection without damaging the delicate structures that make up the labyrinth.
As viral labyrinthitis is much more common, doctors can usually safely assume that labyrinthitis is the result of a viral infection unless there is strong evidence to suggest otherwise, such as:
Further testing is usually only required if you have additional symptoms that suggest you may have a more serious condition, such as meningitis or a stroke. Symptoms can include:
These tests can include:
Labyrinthitis is usually treated using a combination of self-help techniques and medication. Chronic labyrinthitis may be treated with vestibular rehabilitation therapy (VRT).
Drink plenty of liquid, particularly water, to avoid becoming dehydrated. You should drink little and often.
In its early stages, labyrinthitis can make you feel constantly dizzy and it can give you severe vertigo. You should rest in bed to avoid falling and injuring yourself. After a few days, the worst of these symptoms should have passed and you should no longer feel dizzy all the time.
If your symptoms of dizziness, vertigo and loss of balance are particularly severe, your doctor may prescribe a short course of medication such as benzodiazepine or antiemetics (vestibular sedatives).
Benzodiazepines reduce activity inside your central nervous system. This means your brain is less likely to be affected by the abnormal signals coming from your vestibular system.
However, long-term use of benzodiazepines is not recommended because they can be highly addictive if used for long periods.
A prescription medication known as an antiemetic may be prescribed if you are experiencing nausea and vomiting.
[Prochlorperazine 5mg tablets] are an antiemetic used to treat the symptoms of vertigo and dizziness. It may be considered as an alternative treatment to benzodiazepines.
Most people are able to tolerate prochlorperazine and side effects are uncommon, but can include tremors (shaking), abnormal or involuntary body and facial movements, and sleepiness.
Check the patient information leaflet that comes with your medicine for a full list of possible side effects.
If you are vomiting, there is a [prochlorperazine 3mg tablet] available which you place inside your mouth between your gums and cheek.
Corticosteroids such as prednisolone may be recommended if your symptoms are particularly severe. They are often effective at reducing inflammation.
Side effects of prednisolone include:
If your labyrinthitis is thought to be caused by a bacterial infection, you will be prescribed antibiotics. Depending on how serious the infection is, this could either be antibiotic tablets or capsules (oral antibiotics) or antibiotic injections (intravenous antibiotics).
A number of antiviral medications are also available, but these are usually less effective than antibiotics and may have a limited effect in speeding up your recovery time. Your doctor may therefore feel there is little benefit in prescribing you this type of medication.
Contact your doctor if you develop additional symptoms that suggest your condition may be getting worse. If this happens, you may be admitted to hospital. These symptoms include:
Also contact your doctor if you do not notice any improvement in your symptoms after three weeks. You may need to be referred to an ear, nose and throat (ENT) specialist.
A small number of people experience symptoms of dizziness and vertigo that last for many months and, in some cases, years. This is sometimes known as chronic labyrinthitis.
The symptoms of chronic labyrinthitis are not usually as severe as when you first get the condition, although even mild dizziness can have a considerable impact on your quality of life, employment and other daily activities.
Vestibular rehabilitation therapy (VRT) is an effective treatment for people with chronic labyrinthitis. VRT attempts to "retrain" your brain and nervous system to compensate for the abnormal signals that come from your vestibular system.
VRT is usually carried out under the supervision of a physiotherapist and involves a range of exercises designed to:
The Brain and Spine Foundation is a UK charity that has more information about vestibular rehabilitation on its website.
Not all physiotherapists have training in VRT, so you need to make it clear you require this type of treatment before making an appointment.
Permanent hearing loss can be a common complication of labyrinthitis, particularly in children who have developed bacterial labyrinthitis as a complication of the brain infection meningitis.
It's estimated that as many as one in five children will develop hearing loss after having meningitis. The hearing loss can either be partial or complete.
Because of the high risk of hearing loss occurring after bacterial labyrinthitis, it is recommended that a person is given a hearing test once they have recovered from the infection.
If your or your child's hearing is severely affected, small devices called cochlear implants may be required. Cochlear implants are inserted into your ears to help improve your hearing.
Read more information about hearing loss.
Important: Our website provides useful information but is not a substitute for medical advice. You should always seek the advice of your doctor when making decisions about your health.