Labyrinthitis



What is Laybyrinthitis?

Labyrinthitis inflammatory reactions may occur in the labyrinths (or semicircular canals) as a result of middle-ear infections. This organ cares for the balance of the body, and symptoms are related to this. It is relatively common following ear infections, but the serious cases of the past are seen very rarely today. Milder attacks are relatively common, but fortunately settle down fairly quickly.

This is a fairly common symptom, and means a subjective sensation of rotary movement, either to the person or of the environment. Often there is inability of the upright body to remain so, and there may be a falling to one side. Sometimes the patient may fall to the floor but the subjective sensation is that the floor has come up and hit the patient. Disorientation occurs.



Vertigo comes from a word meaning a turning, and the sense of rotation that takes place is an apt description of symptoms. The so-called eighth cranial nerve (the auditory nerve) has two parts. One, the auditory component, is concerned with the appreciation of sound. The other, called the vestibular part, supplies the balance mechanism located within the inner part of the ear.

Often infections of the labyrinths (commonly in association with an upper respiratory tract viral infection – often called URTI) may adversely affect the vestibular nerve and mechanism. So an acute labyrinthitis may occur. Symptoms include intense vertigo, usually with a marked tinnitus (ringing sensation in the ears), a staggering gait, and possibly irregular eye movements may occur.



Labyrinthitis Symptoms

General labyrinthine signs occur, chiefly in the form of giddiness, vomiting, vertigo, nystagmus and loss of balance. The degree of symptoms will vary considerably, and some or all may be present. Nystagmus means that there is a jerky movement of the eyes, which may indicate a more advanced state of infection.

Labyrinthitis Treatment

While labyrinthitis occasionally arises as a complication of otitis media, in most it is probably viral in origin; antibiotics are not helpful unless otitis media is present. Labyrinthitis normally resolves on its own within a few days. However, this illness should be evaluated by your child’s physician to rule out any other causes of vertigo and, if necessary begin medication to relieve symptoms.



If symptoms are causing discomfort, then bed rest for a few days, or until symptoms have totally subsided, is advised. Antibiotics are usually given in full courses, and orally administered penicillins and semisynthetic penicillins, such as amoxycillin or the cephalosporins, are still probably the best first-line approach. These must be ordered by the doctor. Dizziness, nausea and vertigo are often relieved by prochlorperazine, given either by injection or orally.

In most cases symptoms subside relatively well, but sometimes serious complications may occur, so that surgery may later be necessary. However, this is in the province of the ENT specialist, who should be consulted in any case, and who probably organized the original line of treatment.



Bed rest for a few days is essential, for it may be impossible to carry on normal activities in the upright position. It is worth treating any concurrent infection (such as an URTI). Antibiotics are usually useless, for this is often viral in nature, and antibiotics will not kill viruses.

Treatment is entirely symptomatic. A darkened room with peace and quiet is often preferable. Sedation or the use of tranquillizers may he ordered by the doctor. Prochlorperazine, either in tablet form (Stemetil) or injection may assist in alleviating the dizziness. But such treatment must be ordered by the physician. As the URTI or intercurrent infection subsides, the symptoms of the labyrinthitis usually decline and phase out with no aftermath.



Any persisting form, of course, needs adequate medical investigation.