Materiały źródłowe

• #1 Labyrinthitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560506/

  Labyrinthitis is an inflammation of the membranous labyrinth of the inner ear and typically presents with vertigo, nausea, vomiting, tinnitus, and/or hearing loss. […] Although most patients will achieve complete recovery, patients may be left with residual balance or hearing problems. […] Many other serious conditions can mimic the symptoms of labyrinthitis, such as a cerebrovascular accident (CVA), which is why it is crucial to perform a thorough history, examination, and investigations before diagnosing labyrinthitis. […] Vestibular neuritis (also termed vestibular neuronitis) is often used interchangeably with labyrinthitis as the symptoms and clinical picture are extremely similar. However, true vestibular neuritis is inflammation confined to the vestibular nerve itself, without membranous labyrinth inflammation.

• #1 Labyrinthitis and vestibular neuritis

  https://www.nhs.uk/conditions/labyrinthitis/

  Labyrinthitis and vestibular neuritis are types of inner ear infection that affect your balance. They usually get better on their own within a few weeks. […] The symptoms of vestibular neuritis are very similar, but it does not cause hearing loss or tinnitus. […] You’ll usually get your balance back over 2 to 6 weeks, although it can take longer. […] Labyrinthitis or vestibular neuritis usually gets better on its own. But there are things you can do to ease the symptoms. […] The GP may refer you to a hospital specialist. […] You may need to be referred to a specialist for tests, and possibly treatment. […] Labyrinthitis and vestibular neuritis are problems with different parts of the inner ear, which are needed for balance: labyrinthitis is inflammation of the labyrinth a maze of fluid-filled channels in the inner ear; vestibular neuritis is inflammation of the vestibular nerve the nerve in the inner ear that sends messages to the brain.

• #1 Types of Vestibular Disorders – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/

  Labyrinthitis and vestibular neuritis are disorders resulting from an infection that inflames the inner ear or the vestibulo-cochlear nerve (the eighth cranial nerve), which connects the inner ear to the brain. Neuritis (inflammation of the nerve) affects the vestibular branch of the vestibulo-cochlear nerve, resulting in dizziness or vertigo but no change in hearing. Labyrinthitis (inflammation of the labyrinth) occurs when an infection affects both branches of the nerve, resulting in hearing changes as well as dizziness or vertigo.

• #1 Vestibular Neuronitis – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/inner-ear-disorders/vestibular-neuronitis

  Vestibular neuronitis causes a self-limited episode of vertigo, presumably due to inflammation of the vestibular division of the 8th cranial nerve; some vestibular dysfunction may persist. […] Sometimes vestibular neuronitis is used synonymously with viral labyrinthitis. However vestibular neuronitis manifests only with vertigo, whereas in viral labyrinthitis, tinnitus, hearing loss, or both are also present. […] The absence of concomitant tinnitus or hearing loss is a hallmark of vestibular neuronitis and helps distinguish it from Meniere disease as well as labyrinthitis. […] If clinicians suspect vestibular neuronitis, tests should include an audiologic assessment, electronystagmography with caloric testing, and gadolinium-enhanced MRI of the head, with attention to the internal auditory canals to exclude other diagnoses, such as cerebellopontine angle tumor, brain stem hemorrhage, or infarction. MRI may show enhancement of the vestibular nerves, consistent with inflammatory neuritis. […] Do tests to exclude other disorders.

• #1 Vestibular neuritis and labyrinthitis – UpToDate

  https://www.uptodate.com/contents/vestibular-neuritis-and-labyrinthitis

  Vestibular neuritis is also known as vestibular neuronitis, labyrinthitis, neurolabyrinthitis, and acute peripheral vestibulopathy. […] Vestibular neuritis also shares clinical features with less benign disorders, particularly acute vascular lesions of the central nervous system, from which it must be accurately differentiated in order to avoid morbidity and mortality. […] This topic will review the pathophysiology, clinical manifestations, diagnosis, and treatment of vestibular neuritis. […] Vestibular neuritis (also known as acute unilateral vestibulopathy [AUVP], vestibular neuronitis, and labyrinthitis) represents an acute, spontaneous, peripheral vestibular ailment, characterized by the rapid onset of severe vertigo with nausea, vomiting, and gait instability.

• #1 Labyrinthitis and vestibular neuritis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labyrinthitis-and-vestibular-neuritis

  Vestibular neuritis and labyrinthitis can be diagnosed based on: your medical history, answers to questions about the initial onset of the symptoms, your current symptoms, a physical examination, results of balance and hearing tests carried out by an audiologist. […] Labyrinthitis and vestibular neuritis are disorders that result in inflammation of the inner ear and the nerve connecting the inner ear to the brain. […] The infections that cause vestibular neuritis and labyrinthitis may resolve without treatment within a few weeks.

• #1 Vestibular Neuronitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549866/

  Vestibular neuritis is a clinical diagnosis, and its the clinician’s task to differentiate this benign self-limiting disease from other central causes such as cerebrovascular syndromes. […] The diagnostic basis is mostly on key signs and symptoms of acute vestibular dysfunction, as mentioned above. However, because vestibular neuritis is a diagnosis of exclusion, the main focus in patients presenting with acute spontaneous vertigo is to rule out a stroke or other central causes. […] Neuroimaging of the brain with MRI or CT imaging is not indicated in most cases but can be helpful when exam findings of a peripheral lesion are inconsistent if risk factors for stroke exist and symptoms do not show improvement within 48 hours. […] Other tests like cervical and ocular vestibular evoked myogenic potentials along with video head impulse testing have made it possible to determine which vestibular division is involved in vestibular neuritis.

• #1 Vestibular Neuritis and Labyrinthitis: Symptoms and Treatment

  https://patient.info/signs-symptoms/dizziness/vestibular-neuritis-and-labyrinthitis-causes-and-treatment

  Vestibular neuritis and labyrinthitis are thought to be caused by a viral infection that affects the inner ear. These two conditions typically cause vertigo, often with sickness (vomiting). […] If you have a typical episode of vestibular neuritis due to infection with a virus, then your doctor will usually be able to diagnose this on the basis of your symptoms and the examination. Tests are not usually needed or helpful. […] You may be referred for other tests; hearing tests, balance tests, etc, if you have symptoms that suggest anything other than a viral infection, or if symptoms are not settling within 3-4 weeks. […] However, if you develop sudden onset vertigo with hearing loss for the first time, assessment in the emergency department is required to perform a scan to ensure this has not been caused by interruption to the blood supply of the inner ear.

• #1 Vestibular Neuritis and Labyrinthitis: Explained by a balance specialist

  https://ca.odyo.com/en/neuritis-and-labyrinthitis

  Vestibular neuritis and labyrinthitis are inner ear disorders causing severe vertigo, but labyrinthitis also involves hearing loss. […] Diagnosis relies on clinical evaluation; hearing tests help distinguish between the two. […] The physical examination should not only allow to confirm the diagnosis, but also pinpoint exactly which ear is affected by the inflammation. […] If your doctor cannot tell you which ear is affected (or at least suggest which ear might be causing the issue), the diagnosis is probably being made loosely. […] Audiometry: Probably the most important test to order urgently. Confirms hearing loss in labyrinthitis (absent in vestibular neuritis). […] The vertigo is similar to what is seen in neuritis, BUT there is associated hearing loss and/or ringing (tinnitus). […] This is a critical distinction to understand. If you do not have hearing loss, you do not have a labyrinthitis.

• #1 Labyrinthitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560506/

  When taking a history from a patient with suspected labyrinthitis, it is important to screen for risk factors. […] On examination, patients will often display nystagmus; the fast phase will move away from the affected ear. […] Audiometry is useful to assess the extent of sensorineural hearing loss. […] The laboratory tests should be tailored to the patient’s symptoms and differential diagnoses. […] Treatment must be tailored to the etiology and symptoms. […] In bacterial labyrinthitis, antibiotic type and route depend on the source. […] The initial management of autoimmune labyrinthitis is corticosteroids. […] Surgical intervention is only required in a minority of cases, for example, mastoidectomy in patients with cholesteatoma or severe mastoiditis. […] The interprofessional team is crucial in delivering optimum care for a patient with labyrinthitis. […] Patients can be left with residual vestibular symptoms, which severely impact their quality of life.

• #1 Labyrinthitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/72

  Labyrinthitis is an inflammatory condition affecting the contents of the otic capsule. This includes the cochlea, three orthogonal semi-circular canals, and the otolith organs (utricle, saccule). […] Diagnosis is supported by history, physical examination, and audiometry. […] Key diagnostic factors include presence of risk factors, vertigo, dizziness, nausea and vomiting, hearing loss, and otorrhoea. […] 1st investigations to order include audiogram, Weber’s test, and Rinne’s test. […] Investigations to consider include CT or MRI brain, electronystagmography, rotary chair test, vestibular-evoked myogenic potentials, syphilis serology, cerebrospinal fluid Gram stain and culture, serum HIV rapid test, and basic metabolic profile (including urea and creatinine).

• #1 Labyrinthitis and Vestibular Neuritis | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labyrinthitis-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. […] 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. […] 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.

• #1 Vestibular neuritis (VN) and labyrinthitis

  https://dizziness-and-balance.com/disorders/unilat/vneurit.html

  New technology has greatly enhanced our ability to detect vestibular neuritis. The VHIT test is both accurate and very quick, as well as unlikely to make a person dizzier than they already are. […] Vestibular neuritis has „hard” criteria – -objective findings on bedside and laboratory testing. It is not a member of the group of dizziness disorders that are based on symptoms alone such as vestibular migraine and PPPD. […] The VHIT test has immensely simplified the differential diagnosis of Vestibular Neuritis. VN is now mainly diagnosed when there is a strong unilateral positive on the VHIT, and symptoms that last longer than a few days. The VHIT is not yet universally available, but its adoption seems to be rapid in the USA. […] A thorough examination including video-frenzel goggles is all that is necessary.

• #1 Vestibular Neuritis and Labyrinthitis | Doctor

  https://patient.info/doctor/vestibular-neuritis-and-labyrinthitis-pro

  An abnormal head impulse test, unidirectional nystagmus and no vertical skew are sensitive markers of vestibular neuritis and of labyrinthitis. […] Routine blood tests are not helpful; neither are viral antibody tests. However, if a systemic infection is suspected, FBC and blood cultures are indicated. […] Most patients do not require imaging. However, a CT scan can help rule out mastoiditis. […] A patient with labyrinthitis or vestibular neuritis is dizzy at rest, feels worse with any head motion and already has spontaneous nystagmus.

• #1 Labyrinthitis and Vestibular Neuritis | Ohio State Medical Center

  https://wexnermedical.osu.edu/ear-nose-throat/hearing-and-balance/labyrinthitis-and-vestibular-neuritis

  Labyrinthitis and vestibular neuritis are types of inner ear infections that can affect your balance. […] When your inner ear isnt working properly, it can cause debilitating symptoms of dizziness, vertigo (feeling as if the room is spinning) and nausea. […] The nationally ranked ear, nose and throat (ENT) doctors at The Ohio State University Wexner Medical Center in Columbus, Ohio, specialize in treating balance conditions like labyrinthitis and vestibular neuritis. […] An otolaryngologist (an ENT doctor) usually diagnoses these conditions; however, they might collaborate with an audiologist or a neurologist depending on your symptoms. The ENT doctor will first perform a physical examination of your ear and talk with you about your medical history. […] With symptoms like sudden onset of vertigo or blurred vision, its important for your doctors to run imaging tests to rule out other, more serious causes (stroke, tumors) of your symptoms. […] Other tests our ENT team might run include: Hearing tests, Balance tests, such as electronystagmography and caloric stimulation, Magnetic resonance imaging (MRI) scans or computed tomography (CT) scans.

• #1 Vestibular Neuritis and Labyrinthitis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vestibular-neuritis-and-labyrinthitis

  Your primary care provider will likely refer your child to a pediatric otolaryngologist (ENT specialist) because diagnosing the cause of vertigo can be challenging. Labyrinthitis and vestibular neuritis must be differentiated from other forms of dizziness. A multidisciplinary team of otolaryngologists, audiologists, and physical therapists is best able to perform the comprehensive evaluation and to know when to call on the expertise of other specialists. […] The otolaryngology evaluation will include: Extensive medical history-taking with questions for both you and your child, Thorough physical exam, especially of the head and ears, Vestibular exam to evaluate their balance and inner ear function. […] During the course of the evaluation, you will meet with a vestibular trained audiologist for an evaluation and further testing. This evaluation may include: Audiologic evaluation (hearing test), Rotational chair testing, which involves your child sitting in a computerized rotating chair, safely secured with a seatbelt, and wearing light weight goggles.

• #1 Labyrinthitis and Vestibular Neuritis – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/

  Vestibular neuritis can be broken down into three subtypes: superior, inferior, or total. Superior neuritis is the most common, followed by total and inferior. The advent of vestibular testing has aided in more accurate diagnosis given that these conditions are peripheral vestibulopathies. Vestibular Evoked Myogenic Potentials (cVEMP/oVEMP), Video Head Impulse Testing (vHIT), Ocular Tilt Reaction, Electronystagmography (ENG), and Videonystagmography (VNG) can all be utilized to pinpoint the lesion and the subtype. An Audiogram may be required if patients experience hearing loss. […] Accurate diagnosis of AUVP/Vestibular Neuritis is of the utmost importance. The first step is to differentiate it from an acute central vestibular syndrome which can often present with similar symptoms in patients with significant cardiovascular risk factors. The physical exam is critical in determining which patients require further workup to rule out a stroke.

• #1 Vestibular Neuritis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/15227-vestibular-neuritis

  In most cases, an otolaryngologist (ENT) diagnoses vestibular neuritis. Some people may also need to see a neurologist (a doctor who specializes in the brain and nervous system) or an audiologist (a hearing specialist). […] To do this, they may request imaging tests. This usually includes an MRI (magnetic resonance imaging) with dye (contrast agent). […] Your healthcare provider may also use the following tests to confirm your diagnosis: Hearing tests. Vestibular test battery. Tests to locate areas of damage on your vestibular nerve.

• #1 Initial Evaluation of Vertigo | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/0115/p244.html

  The Dix-Hallpike maneuver may be the most helpful test to perform on patients with vertigo. It has a positive predictive value of 83 percent and a negative predictive value of 52 percent for the diagnosis of BPPV. […] Laboratory tests such as electrolytes, glucose, blood counts, and thyroid function tests identify the etiology of vertigo in fewer than 1 percent of patients with dizziness. […] Physicians should consider neuroimaging studies in patients with vertigo who have neurologic signs and symptoms, risk factors for cerebrovascular disease, or progressive unilateral hearing loss. […] In general, magnetic resonance imaging is more appropriate than computed tomography for diagnosing vertigo because of its superiority in visualizing the posterior fossa, where most central nervous system disease that causes vertigo is found.

• #1 Labyrinthitis and vestibular neuritis | Handouts | MedLink Neurology

  https://www.medlink.com/handouts/labyrinthitis-and-vestibular-neuritis

  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. […] 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. […] Physicians and audiologists will review test results to determine whether permanent damage to hearing has occurred and whether hearing aids may be useful. […] If symptoms of dizziness or imbalance are chronic and persist for several months, vestibular rehabilitation exercises (a form of physical therapy) may be suggested in order to evaluate and retrain the brain’s ability to adjust to the vestibular imbalance.

• #1 Vestibular Neuritis and Labyrinthitis | Doctor

  https://patient.info/doctor/vestibular-neuritis-and-labyrinthitis-pro

  Vestibular neuritis and labyrinthitis are sometimes used interchangeably. However, experts in the field recommend that the term 'vestibular neuritis’ be confined to cases in which the vestibular nerve only is involved, with the term 'labyrinthitis’ being used in cases in which the vestibular nerve and the labyrinth are affected. […] Characteristically, vestibular neuritis and labyrinthitis both present with sudden, spontaneous, severe and often incapacitating vertigo. […] Although neither vestibular neuritis nor labyrinthitis is life threatening, it is essential to distinguish each from other disorders, such as a TIA, stroke or brain tumour. […] The HINTS examination refers to the combination of Head impulse test, Nystagmus Type and Skew and is used in patients presenting with acute, ongoing vertigo and spontaneous nystagmus, to differentiate vestibular neuritis or labyrinthitis from stroke.

• #1 Vestibular Neuritis and Viral Labyrinthitis | Tampa Bay Hearing and Balance Center

  https://www.tampabayhearing.com/ear-education/vestibular-education/vestibular-neuritis-and-viral-labyrinthitis/

  The principle physical finding is spontaneous nystagmus most often with a rotational component toward the unaffected ear but this finding is not unique to acute vestibular neuritis. […] Observers most commonly report horizontal but rotary nystagmus to some degree is present a high percentage as a spontaneous nystagmus, present without provocation. […] The HIT can be abnormal for other reasons and is not 100% sensitive but it is the physical examination test in addition to presence of nystagmus most likely to be abnormal. […] Standing heel to toe, eyes closed (the tandem Romberg test) is more sensitive. […] Vestibular neuritis patients should not also have both abnormal vertical pursuit and skew deviation. […] In summary, vestibular pseudoneuritis, acute pontomedullary brainstem lesions or cerebellar nodular infarctions, vestibular migraine, and an initial vestibular Mnires disease event may superficially look like vestibular neuritis.

• #1 Vestibular Neuronitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK549866/

  The treatment of vestibular neuritis usually consists of acute symptomatic treatment with medications such as antiemetics (promethazine, metoclopramide), antihistamines (diphenhydramine, meclizine), and benzodiazepines (diazepam, lorazepam). Following the acute phase, other therapies, such as vestibular rehabilitation, are often recommendations. […] The utilization of the above antiemetics, antihistamines, and benzodiazepines should be used for no more than three days or so as these medications can delay central compensation and lead to chronic problems and recurrent vertigo. […] The differential diagnosis in patients presenting with vertigo can be broken down to that of peripheral or central etiologies as well as those with or without hearing loss. […] The natural history of this disease is uncomplicated with complete resolution in most cases. Some can have incomplete resolution and with a study showing 15% with persistent symptoms at one year. […] Recurrence of vestibular neuritis is infrequent, with studies that have shown its recurrence in only 2 to 11% of patients.

• #1 Labyrinthitis and Vestibular Neuritis – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/

  Vestibular migraine can be difficult to differentiate from a vestibular neuritis episode, but the repetitive, stereotypical nature of the episodes with or without migraine headaches often leads to the diagnosis. […] Labyrinthitis resulting in ear pain, hearing loss, and possibly tinnitus. […] In the acute phase, patients experience the symptoms continuously, even at rest, with worsening of their symptoms on movement. Patients may also be inclined to lay with their healthy ear facing downwards, although there is no evidence to indicate this maneuver improves symptom severity. […] Supportive treatment is the mainstay of the acute phase. Medications tailored to decrease nausea, vomiting, and vertigo should be utilized. However, caution must be taken to not prolong treatment with these medications as they can inhibit compensatory mechanisms employed by the brain. Common medications prescribed as supportive treatment include Meclizine, Promethazine Hydrochloride, Antivirals, Antibiotics, Diphenhydramine, Ondansetron, and Benzodiazepines. Unless contraindicated, we typically also prescribe high-dose steroids.

• #1 Vestibular Neuritis and Labyrinthitis | enteducationswansea

  https://www.enteducationswansea.org/vestibular-neuritis-and-labyrinthit

  Patients with acute vestibular failure as in labyrinthitis and vestibular neuritis are often pale and sweaty and are reluctant to move for fear of worsening their symptoms of nausea and vomiting. They will have nystagmus in addition. This is almost always towards the opposite ear. […] Examination early on will reveal this uni-directional nystagmus in all directions of gaze. Later, as compensation starts to occur, the nystagmus will only be seen when the patient looks in the direction of the fast phase of the nystagmus. […] If there is associated hearing loss tuning fork tests will suggest that this is of a sensorineural type. […] Note that the patient will not be suffering with signs or symptoms of posterior fossa disease: dysarthria, diplopia, facial weakness, dysphagia, loss of vision, facial or limb paraesthesia, limb weakness, etc. These posterior fossa symptoms and their associated signs point to neurological disease such as a circulatory disturbance and the patient will require emergency brain imaging.

• #1 Labyrinthitis and vestibular neuritis | Handouts | MedLink Neurology

  https://www.medlink.com/handouts/labyrinthitis-and-vestibular-neuritis

  Labyrinthitis and vestibular neuritis are disorders resulting from an infection that inflames the inner ear or the vestibulo-cochlear nerve (the eighth cranial nerve), which connects the inner ear to the brain. […] Although the symptoms of bacterial and viral infections may be similar, the treatments are very different, so proper diagnosis by a physician is essential. […] No specific tests exist to diagnose vestibular neuritis or labyrinthitis. Therefore, a process of elimination is often necessary to diagnose the condition. […] 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.

• #1 The Vertigo Therapist

  https://thevertigotherapist.com/vestibular-neuritis-labyrinthitis/

  Both conditions cause a sudden onset of moderate to severe vertigo that lasts for at least one day, up to several days. […] Diagnosis: There are no specific tests that can identify Vestibular Neuritis or Labyrinthitis. A thorough medical examination is necessary to rule out other causes of dizziness and vertigo. The diagnosis is often given based on your symptoms and a physical examination. Your doctor may send you for a VNG (video-nystagmography) test which can help to determine if there has been damage to nerves that connect to the inner ear.

• #1 Labyrinthitis and vestibular neuritis

  https://www.nhs.uk/conditions/labyrinthitis/

  If you have labyrinthitis or vestibular neuritis, a GP may prescribe antihistamines or motion sickness tablets for up to 3 days. Do not take them for any longer, as they can slow down your recovery. […] Labyrinthitis or vestibular neuritis is usually caused by a viral infection, such as a cold or flu, so antibiotics will not help. But a GP may prescribe antibiotics if they think your infection is bacterial. […] Vestibular rehabilitation is a series of exercises that can help restore balance. You should only do the exercises under the supervision of a specialist such as a physiotherapist or audiologist.

• #2 Vestibular Neuritis and Labyrinthitis | Doctor

  https://patient.info/doctor/vestibular-neuritis-and-labyrinthitis-pro

  Vestibular neuritis and labyrinthitis are sometimes used interchangeably. However, experts in the field recommend that the term 'vestibular neuritis’ be confined to cases in which the vestibular nerve only is involved, with the term 'labyrinthitis’ being used in cases in which the vestibular nerve and the labyrinth are affected. […] Characteristically, vestibular neuritis and labyrinthitis both present with sudden, spontaneous, severe and often incapacitating vertigo. […] Although neither vestibular neuritis nor labyrinthitis is life threatening, it is essential to distinguish each from other disorders, such as a TIA, stroke or brain tumour. […] The HINTS examination refers to the combination of Head impulse test, Nystagmus Type and Skew and is used in patients presenting with acute, ongoing vertigo and spontaneous nystagmus, to differentiate vestibular neuritis or labyrinthitis from stroke.

• #2 Labyrinthitis Differential Diagnoses

  https://emedicine.medscape.com/article/856215-differential

  Viral labyrinthitis is often confused with vestibular neuritis, and the terms are occasionally used interchangeably in the literature. However, most authors agree that vestibular neuritis is a disorder of the vestibular nerve and is not associated with hearing loss. […] Vestibular neuritis typically manifests as sudden, acute vertigo without hearing loss in an otherwise healthy patient. The condition is more common in the fourth and fifth decades of life and affects men and women equally. An upper respiratory tract infection often precedes the condition, and the disorder is more common in the spring and early summer. […] Histopathologic nerve studies of patients with vestibular neuritis demonstrate axonal loss, endoneurial fibrosis, and atrophy. These findings are consistent with a viral inflammatory etiology. The treatment of vestibular neuritis and viral labyrinthitis is similar.

• #2 Labyrinthitis and Vestibular Neuritis | Otolaryngology | Loyola Medicine

  https://www.loyolamedicine.org/services/otolaryngology-ent/otolaryngology-conditions/labyrinthitis-vestibular-neuritis

  Labyrinthitis and vestibular neuritis occur when irritation, inflammation or infection of your inner ear affects the vestibular nerves. […] The main difference between vestibular neuritis and labyrinthitis is that labyrinthitis also affects hearing. […] Seeing an otolaryngologist, or doctor specializing in diseases of the ear, nose and throat, is your best option for discovering if you have labyrinthitis. […] The otolaryngologist will take a detailed history and perform a physical exam and conduct a few tests to try and determine the cause of your symptoms. Such tests could include: Audiogram (hearing test), An in-office vestibular examination, Videonystagmography: this is an in-depth test to learn more about the strength of your balance system.

• #2 Understanding Neuritis And Labyrinthitis: Become An Expert

  https://thevertigodoctor.com/blog/navigating-labyrinthitis-and-neuritis/

  Labyrinthitis occurs when the labyrinth becomes inflamed. This inflammation disrupts the transmission of sensory information from the inner ear to the brain, leading to symptoms such as vertigo, nausea, vomiting, and difficulty focusing. This type of inflammation can result in hearing loss. […] Vestibular neuritis specifically refers to inflammation or infection of the vestibular nerve, often resulting from a viral infection. It typically presents with sudden, severe vertigo that can last for days to weeks, accompanied by nausea and imbalance. While the exact cause of vestibular neuritis is not always clear, its often associated with viral infections such as the herpes simplex virus or the varicella-zoster virus. This type of inflammation or infection does not typically result in hearing loss.

• #2 Labyrinthitis – WikEM

  https://wikem.org/wiki/Labyrinthitis

  Some sources consider vestibular neuritis and labyrinthitis to be the same thing (some differentiate based on auditory symptoms) […] Acute suppurative labyrinthitis is only cause of peripheral vertigo requiring urgent treatment […] Clinical course similar to Vestibular Neuritis (Neuronitis) […] Labyrinthitis […] Vestibular neuritis.

• #2 Labyrinthitis – symptoms, treatments and causes | healthdirect

  https://www.healthdirect.gov.au/labyrinthitis

  Labyrinthitis and vestibular neuritis are disorders that result in inflammation of the inner ear and the nerve connecting the inner ear to the brain. […] How is labyrinthitis diagnosed? Your doctor will talk to you and examine you. The examination may include: asking you to move your head rapidly from side-to-side or up and down, checking whether you have an ear infection, hearing tests, checking your eye movements flickering can be a sign that your balancing system is not working properly. […] In some cases, your doctor may also organise tests such as: blood tests, a lumbar puncture, a CT scan, an MRI scan. This can help rule out serious conditions such as meningitis or a stroke.

• #2 Labyrinthitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/l/labyrinthitis.html

  Labyrinthitis is the inflammation of part of the inner ear called the labyrinth. […] Your healthcare provider will ask about your health history. You may also have a physical exam. This may include hearing and balance tests. It will also include an exam of your nervous system. Many neurological and other health conditions can cause dizziness and vertigo. Your provider may need to rule these out. […] There are no tests for labyrinthitis. But your provider may have you take an imaging test. This can help to rule out other causes of your symptoms, such as stroke. […] Your healthcare provider will need to rule out other more dangerous causes of vertigo, such as stroke.

• #2 Labyrinthitis and Vestibular Neuritis | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labyrinthitis-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. […] 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. […] 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.

• #2 Labyrinthitis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/72

  Labyrinthitis is an inflammatory condition affecting the contents of the otic capsule. This includes the cochlea, three orthogonal semi-circular canals, and the otolith organs (utricle, saccule). […] Diagnosis is supported by history, physical examination, and audiometry. […] Key diagnostic factors include presence of risk factors, vertigo, dizziness, nausea and vomiting, hearing loss, and otorrhoea. […] 1st investigations to order include audiogram, Weber’s test, and Rinne’s test. […] Investigations to consider include CT or MRI brain, electronystagmography, rotary chair test, vestibular-evoked myogenic potentials, syphilis serology, cerebrospinal fluid Gram stain and culture, serum HIV rapid test, and basic metabolic profile (including urea and creatinine).

• #2 Vestibular neuritis (VN) and labyrinthitis

  https://dizziness-and-balance.com/disorders/unilat/vneurit.html

  The VHIT test is particularly good for diagnosis as it is very efficient in detecting vestibular neuritis and is generally normal in strokes. […] In severe or complex situations, we will sometimes (not always) order the following tests: Rotatory chair test, Audiogram, VEMP, VHIT testing, MRI of brain and IAC, with and without contrast, Blood testing. […] An example of a positive VENG: This caloric test was done 1 month after acute onset of vestibular neuritis. The left ear is normal, the right shows no response. […] Testing (i.e. an audiogram, VEMP, VHIT and others) is indicated to be certain that this is indeed the correct diagnosis. A vestibular rehabilitation program may help speed full recovery via compensation.

• #2 Vestibular Neuritis & Labyrinthitis Treatment Melbourne

  https://thevertigoco.com.au/vestibular-neuritis-labyrinthitis/

  Vestibular Neuritis is diagnosed based on the description of your symptoms and a thorough medical history. Your physiotherapist will perform a comprehensive assessment to determine whether the cause of your symptoms is likely due to vestibular neuritis or labyrinthitis. This includes a variety of tests that focus on eye and head movements and balance. One in particular is the Head Impulse Test (HIT) which confirms the diagnosis of the Vestibular Neuritis/Labyrinthitis. […] If required, you may also be referred for Vestibular Function Testing (VFTs) with a Vestibular Audiologist. This involves comprehensive diagnostic testing of your inner ear function. This testing can determine the type of vestibular neuritis you have: superior, inferior or total. Superior is most common, followed by inferior and total.

• #2 Vestibular Neuritis and Labyrinthitis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vestibular-neuritis-and-labyrinthitis

  Your primary care provider will likely refer your child to a pediatric otolaryngologist (ENT specialist) because diagnosing the cause of vertigo can be challenging. Labyrinthitis and vestibular neuritis must be differentiated from other forms of dizziness. A multidisciplinary team of otolaryngologists, audiologists, and physical therapists is best able to perform the comprehensive evaluation and to know when to call on the expertise of other specialists. […] The otolaryngology evaluation will include: Extensive medical history-taking with questions for both you and your child, Thorough physical exam, especially of the head and ears, Vestibular exam to evaluate their balance and inner ear function. […] During the course of the evaluation, you will meet with a vestibular trained audiologist for an evaluation and further testing. This evaluation may include: Audiologic evaluation (hearing test), Rotational chair testing, which involves your child sitting in a computerized rotating chair, safely secured with a seatbelt, and wearing light weight goggles.

• #2 What is an Inner Ear Infection (Vestibular Neuritis and Labyrinthitis)? — Sonia Vovan Physiotherapy

  https://soniavovan.com/blog/what-is-an-inner-ear-infection-vestibular-neuritis-and-labyrinthitis

  There are no specific tests that can confirm the diagnosis of vestibular neuritis or labyrinthitis. It is usually a diagnosis of exclusion, meaning that a series of tests are conducted to eliminate other potential causes of the same symptoms, 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. […] If symptoms persist, additional testing may be required to help determine whether a different vestibular disorder could be the cause of the persistent symptoms. These tests can include an audiogram (hearing test), electronystagmography (ENG), or videonystagmography (VNG), which may include a caloric test to measure any differences between the function of the two sides of the vestibular system. Vestibular-evoked myogenic potentials (VEMP) may also be performed to detect damage in a particular portion of the vestibular nerve.

• #2 Vestibular Neuronitis – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/inner-ear-disorders/vestibular-neuronitis

  Vestibular neuronitis is a disorder characterized by a sudden severe attack of vertigo (a false sensation of moving or spinning) caused by inflammation of the vestibular nerve, the branch of the 8th cranial nerve that helps control balance. […] The diagnosis of vestibular neuronitis involves hearing tests and tests for nystagmus, which help doctors diagnose the cause of vertigo. […] Gadolinium-enhanced MRI of the head should be done to make sure the symptoms are not caused by another disorder, such as a tumor.

• #2 Vestibular neuritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vestibular-neuritis?lang=us

  Vestibular neuritis, also known as acute unilateral vestibulopathy (AUVP) or vestibular neuronitis, refers to presumed inflammation of the vestibular nerve/vestibulocochlear nerve. It can be associated with labyrinthitis. […] MRI with contrast is sometimes requested in order to exclude other causes of sudden onset dizziness and vertigo such as stroke (especially AICA territory strokes) and brain tumors, especially in the elderly. However, typically the MRI is normal in vestibular neuritis. […] Corticosteroids, antiemetics and vestibular physiotherapy are standard supportive measures of care. No antiviral or antibacterial therapy is usually necessary. Recurrence is rare and most patients will show full recovery.

• #2 Labyrinthitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560506/

  When taking a history from a patient with suspected labyrinthitis, it is important to screen for risk factors. […] On examination, patients will often display nystagmus; the fast phase will move away from the affected ear. […] Audiometry is useful to assess the extent of sensorineural hearing loss. […] The laboratory tests should be tailored to the patient’s symptoms and differential diagnoses. […] Treatment must be tailored to the etiology and symptoms. […] In bacterial labyrinthitis, antibiotic type and route depend on the source. […] The initial management of autoimmune labyrinthitis is corticosteroids. […] Surgical intervention is only required in a minority of cases, for example, mastoidectomy in patients with cholesteatoma or severe mastoiditis. […] The interprofessional team is crucial in delivering optimum care for a patient with labyrinthitis. […] Patients can be left with residual vestibular symptoms, which severely impact their quality of life.

• #2 Labyrinthitis and Vestibular Neuritis – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/

  Vestibular migraine can be difficult to differentiate from a vestibular neuritis episode, but the repetitive, stereotypical nature of the episodes with or without migraine headaches often leads to the diagnosis. […] Labyrinthitis resulting in ear pain, hearing loss, and possibly tinnitus. […] In the acute phase, patients experience the symptoms continuously, even at rest, with worsening of their symptoms on movement. Patients may also be inclined to lay with their healthy ear facing downwards, although there is no evidence to indicate this maneuver improves symptom severity. […] Supportive treatment is the mainstay of the acute phase. Medications tailored to decrease nausea, vomiting, and vertigo should be utilized. However, caution must be taken to not prolong treatment with these medications as they can inhibit compensatory mechanisms employed by the brain. Common medications prescribed as supportive treatment include Meclizine, Promethazine Hydrochloride, Antivirals, Antibiotics, Diphenhydramine, Ondansetron, and Benzodiazepines. Unless contraindicated, we typically also prescribe high-dose steroids.

• #2 Labyrinthitis | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/labyrinthitis/

  Labyrinthitis usually starts suddenly and can be worrying. You should seek medical advice straight away. […] Your GP may: ask about your symptoms, check your medical history, carry out a physical examination you may be asked to move your head or body and they can check your ears for signs of inflammation and infection, test your hearing labyrinthitis is more likely if you have hearing loss, check your eyes if theyre flickering uncontrollably your balancing system may not be working properly. […] Many people diagnosed with labyrinthitis only experience the balance symptoms without hearing loss. This is known as vestibular neuronitis rather than labyrinthitis. Both names are often used to describe the same diagnosis.

• #2 Labyrinthitis – ENT Health

  https://www.enthealth.org/conditions/labyrinthitis/

  Labyrinthitis is a disorder associated with inflammation of the inner ear. […] Patients with labyrinthitis can experience hearing loss in the affected ear, imbalance, dizziness, and nausea. […] Failure to seek treatment may put patients at higher risk for permanent hearing loss and imbalance. […] Patients with substantial balance issues may benefit from physical therapy, specifically vestibular physical therapy. […] Your ENT (ear, nose, and throat) specialist, or otolaryngologist, may order an MRI to rule out this condition. […] The treatment of bacterial labyrinthitis is to control the primary infection, which is usually a middle ear infection. […] A multidisciplinary team involving your ENT specialist, audiologist, and vestibular therapist is important to evaluate your hearing, minimize the potential long-term effects of labyrinthitis, and discuss options for possibly restoring your hearing. […] Patients with sudden, persistent vertigo or additional worsening symptoms such as double vision, slurred speech, facial droop, limb weakness, or numbness should seek immediate medical attention.

• #2 Labyrinthitis and vestibular neuritis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labyrinthitis-and-vestibular-neuritis

  Vestibular neuritis and labyrinthitis can be diagnosed based on: your medical history, answers to questions about the initial onset of the symptoms, your current symptoms, a physical examination, results of balance and hearing tests carried out by an audiologist. […] Labyrinthitis and vestibular neuritis are disorders that result in inflammation of the inner ear and the nerve connecting the inner ear to the brain. […] The infections that cause vestibular neuritis and labyrinthitis may resolve without treatment within a few weeks.

• #3 Labyrinthitis and Vestibular Neuritis – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/

  Vestibular neuritis can be broken down into three subtypes: superior, inferior, or total. Superior neuritis is the most common, followed by total and inferior. The advent of vestibular testing has aided in more accurate diagnosis given that these conditions are peripheral vestibulopathies. Vestibular Evoked Myogenic Potentials (cVEMP/oVEMP), Video Head Impulse Testing (vHIT), Ocular Tilt Reaction, Electronystagmography (ENG), and Videonystagmography (VNG) can all be utilized to pinpoint the lesion and the subtype. An Audiogram may be required if patients experience hearing loss. […] Accurate diagnosis of AUVP/Vestibular Neuritis is of the utmost importance. The first step is to differentiate it from an acute central vestibular syndrome which can often present with similar symptoms in patients with significant cardiovascular risk factors. The physical exam is critical in determining which patients require further workup to rule out a stroke.

• #3 Labyrinthitis and Vestibular Neuritis – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/labyrinthitis-and-vestibular-neuritis/

  Evidence has shown that steroid use does improve canal paresis in the acute phase. However, no significant improvement has been seen in dizziness, chronic canal paresis, or symptomatic recovery. […] Some patients do not compensate completely and continue to suffer from chronic imbalance following an episode of vestibular neuronitis. Paraclinical investigations can help confirm the site of lesion, and timely referral to vestibular rehabilitation should be made to help the patient work on compensatory strategies. This can help the central nervous system compensate for peripheral vestibular insults. […] Vestibular rehabilitation is crucial in ensuring improvement of dynamic and chronic symptoms. Central compensation may take months to years for patients to achieve. However, this is crucial to establish a better quality of life for patients experiencing debilitating symptoms.

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