Materiały źródłowe

• #1 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery. […] Common labyrinthitis medications include: Antivirals (if a virus caused it), Antibiotics (if a bacterium caused it), Corticosteroids to reduce nerve inflammation, Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine). […] If your symptoms dont improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance. […] You can also try home remedies to ease labyrinthitis symptoms: Apply a warm compress over your ear, Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear), Limit alcohol intake, Try stress management techniques, like mindfulness or meditation.

• #2 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Vestibular neuritis is characterized by acute spontaneous vertigo without hearing loss and is the third most common peripheral vestibular disorder, after benign paroxysmal positional vertigo and Meniere disease. […] Therefore, various treatments have been used for vestibular neuritis, such as corticosteroids, antivirals, and vestibular rehabilitation exercises. […] Various treatments for vestibular neuritis have been reported, which can be largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. […] Symptomatic therapy reduces anxiety by explaining in detail the cause, treatment, and prognosis of vestibular neuritis in patients, and provides psychological support by explaining that daily life is possible in a short period of time. […] Vestibular suppressants are widely used because they are effective against dizziness, nausea, and vomiting.

• #3 Vestibular Neuritis: Symptoms, Causes & Treatment

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

  Vestibular neuritis is an inner ear disorder that causes symptoms such as sudden, severe vertigo, dizziness, balance problems, nausea and vomiting. Treatment typically involves managing symptoms or taking antiviral medications. […] The main goal of vestibular neuritis treatment is to manage your symptoms. To do this, your healthcare provider may recommend: Medications (antivirals and drugs to treat nausea, dizziness and inflammation). […] Your healthcare provider may use a variety of medications to ease your vestibular neuritis symptoms, such as: Anti-nausea medications, Drugs to reduce dizziness, Drugs to reduce inflammation, Antiviral medications. […] If balance and dizziness problems last longer than a few weeks, your healthcare provider may recommend vestibular rehabilitation therapy. The goal of this program is to retrain your brain to adapt to the changes you experience.

• #4 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  The initial treatment for viral labyrinthitis consists of bed rest and hydration. Most patients can be treated on an outpatient basis. However, they should be cautioned to seek further medical care for worsening symptoms, especially neurologic symptoms (eg, diplopia, slurred speech, gait disturbances, localized weakness or numbness). Patients with severe nausea and vomiting may benefit from intravenous (IV) fluid and antiemetic medications. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Treatment of suppurative labyrinthitis is aimed at eradicating the underlying infection, providing supportive care to the patient, draining middle ear effusions or mastoid infections, and preventing the spread of infection. […] In cases of labyrinthitis resulting from otitis media, perform a myringotomy and evacuate the effusion. A ventilation tube also may be indicated. Middle ear effusion should be sent for microscopic evaluation, as well as culture and sensitivity.

• #5 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery. […] Common labyrinthitis medications include: Antivirals (if a virus caused it), Antibiotics (if a bacterium caused it), Corticosteroids to reduce nerve inflammation, Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine). […] If your symptoms dont improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance. […] You can also try home remedies to ease labyrinthitis symptoms: Apply a warm compress over your ear, Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear), Limit alcohol intake, Try stress management techniques, like mindfulness or meditation.

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

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

  In vestibular neuritis and labyrinthitis symptoms resolve without treatment after several weeks. […] Anti-nausea medications may be prescribed to help with initial symptoms. […] On some occasions, medications may be prescribed by your otolaryngologists if necessary. […] If vertigo does not resolve after several weeks, vestibular rehabilitation therapy by specially trained physical therapists may be recommended to help retrain the brain to adapt and compensate for the incorrect signals. […] In labyrinthitis hearing loss may or may not improve. […] If hearing loss does not improve, hearing technology may be recommended.

• #7 Vestibular Neuritis: Symptoms, Causes & Treatment

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

  Vestibular neuritis is an inner ear disorder that causes symptoms such as sudden, severe vertigo, dizziness, balance problems, nausea and vomiting. Treatment typically involves managing symptoms or taking antiviral medications. […] The main goal of vestibular neuritis treatment is to manage your symptoms. To do this, your healthcare provider may recommend: Medications (antivirals and drugs to treat nausea, dizziness and inflammation). […] Your healthcare provider may use a variety of medications to ease your vestibular neuritis symptoms, such as: Anti-nausea medications, Drugs to reduce dizziness, Drugs to reduce inflammation, Antiviral medications. […] If balance and dizziness problems last longer than a few weeks, your healthcare provider may recommend vestibular rehabilitation therapy. The goal of this program is to retrain your brain to adapt to the changes you experience.

• #8 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery. […] Common labyrinthitis medications include: Antivirals (if a virus caused it), Antibiotics (if a bacterium caused it), Corticosteroids to reduce nerve inflammation, Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine). […] If your symptoms dont improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance. […] You can also try home remedies to ease labyrinthitis symptoms: Apply a warm compress over your ear, Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear), Limit alcohol intake, Try stress management techniques, like mindfulness or meditation.

• #9 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #10 Labyrinthitis | NHS inform

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

  Youll usually have already seen your GP about labyrinthitis symptoms and may have started some treatment. There are things you can also do during this time to help manage your symptoms at home. […] If your symptoms are particularly severe, your GP may prescribe: prochlorperazine can help with dizziness and sickness, antiemetic can help if youre feeling sick and vomiting, corticosteroids can help by reducing inflammation. […] Chronic labyrinthitis requires a treatment called vestibular rehabilitation therapy (VRT). VRT is usually supervised by a physiotherapist. You can ask your GP to refer you or you can pay for private treatment.

• #11 Labyrinthitis and vestibular neuritis

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

  Labyrinthitis or vestibular neuritis usually gets better on its own. But there are things you can do to ease the symptoms. […] 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.

• #12 Labyrinthitis: Causes, Symptoms, Treatment, Diagnosis & More

  https://www.healthline.com/health/labyrinthitis

  The treatment for labyrinthitis usually involves using medications to control your symptoms. Most people find relief from symptoms within one to three weeks and achieve full recovery in a month or two. […] Symptoms can be relieved with medications, including: prescription antihistamines, such as desloratadine (Clarinex); medications that can reduce dizziness and nausea, such as meclizine (Antivert); sedatives, such as diazepam (Valium); corticosteroids, such as prednisone; over-the-counter antihistamines, such as fexofenadine (Allegra), diphenhydramine (Benadryl), or loratadine (Claritin). […] If you have an active infection, your doctor will probably prescribe antibiotics. […] In addition to taking medications, there are several techniques you can use to relieve vertigo: Avoid quick changes in position or sudden movements. Sit still during a vertigo attack. Get up slowly from a lying down or seated position. Avoid television, computer screens, and bright or flashing lights during a vertigo attack. If vertigo occurs while you’re in bed, try sitting up in a chair and keeping your head still. Low lighting is better for your symptoms than darkness or bright lights. […] If your vertigo continues for a long time, physical and occupational therapists can teach you exercises to help improve balance.

• #13 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #14 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

  Medications such as meclizine or lorazepam to relieve vertigo. […] Medications such as prochlorperazine to relieve vomiting. […] Sometimes corticosteroids such as prednisone. […] Intravenous fluids if vomiting persists. […] Physical therapy. […] In people with vestibular neuronitis, treatment of vertigo is done only to relieve the symptoms it causes and consists of medications such as meclizine or lorazepam. Nausea and vomiting may be relieved by pills or suppositories containing medications that relieve nausea (such as prochlorperazine). These medications should be used only for a short amount of time because prolonged use may lengthen the duration of symptoms, particularly in older people. Additionally, corticosteroids are used briefly. If vomiting continues for a long time, a person may need to be given fluids and electrolytes by vein (intravenously). […] A specialized form of physical therapy, called vestibular therapy, may be helpful.

• #15 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #16 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Regarding specific drug therapy, steroid therapy has been reported to relieve dizziness and promote vestibular compensation in vestibular neuritis; methylprednisolone is much more effective than placebo in reducing vertiginous symptoms in patients with acute vestibular vertigo. […] In vestibular rehabilitation therapy, the goals are to improve vertigo, gaze stability, postural stability, and daily living activities through vestibular compensation and central neuroplasticity. […] Vestibular rehabilitation exercises are mainly divided into generalized and customized vestibular exercises. […] Vestibular exercises significantly hasten vestibulospinal compensation in patients with acute vestibular neuritis. […] The persistent imbalance that some patients experience after acute vestibular neuritis may be due to many factors, including inadequate central compensation, incomplete peripheral recovery, and psychophysiological and psychological features.

• #17 Labyrinthitis and vestibular neuritis

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

  Labyrinthitis or vestibular neuritis usually gets better on its own. But there are things you can do to ease the symptoms. […] 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.

• #18 Vestibular neuritis: Treatment and symptoms

  https://www.medicalnewstoday.com/articles/vestibular-neuritis

  Taking certain medications, practicing exercises, and adapting the diet may help. […] During the acute stage of vestibular neuritis, a doctor may prescribe: antihistamines, such as diphenhydramine or meclizine; antiemetics, such as promethazine or metoclopramide; benzodiazepines, such as diazepam or lorazepam. […] These medications may help suppress nausea and dizziness. […] It is crucial to take these medications for 3 days at most. Continued use can prevent the brain from compensating for the vertigo, and this can lead to ongoing vertigo. […] The doctor may also prescribe antiviral or antibiotic medications to treat any underlying infection. […] The doctor may also recommend vestibular rehabilitation. This involves performing a series of exercises to help regain balance and reduce vertigo.

• #19 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. […] Medication may help to ease symptoms. […] Treatment options for vestibular neuritis and labyrinthitis include: […] A doctor may prescribe anti-sickness medication if you are troubled by being sick (vomiting). Some medicines also help to quieten the nerve messages from the inner ear and may ease vertigo – for example, prochlorperazine. […] If symptoms do not clear within a few weeks then you may be referred to a physical therapy (physiotherapy) specialist who may recommend vestibular rehabilitation. This treatment uses physical and occupational therapy techniques to treat vertigo and balance disorders. […] Treatment of other less common causes depends on the cause. Your doctor will advise. For example, if you have an infection with a germ (bacterium) in your middle ear you may be prescribed antibiotic medication.

• #20 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

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

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

  For chronic and recurring vestibular neuritis and its derivative disorders, Mnires disease and benign paroxysmal positioning vertigo, there is evidence that long term antivirals are effective but dosage is not specified. […] Our clinical experience mirrors that of R Gacek and is that a high percentage of patients with chronic or recurring vestibular neuritis induce remission of symptoms on high dose valacyclovir; that fewer do so on long term acyclovir and as dose drops below 500 mg valacyclovir po TID, the recrudescence rate goes up. […] In summary, a growing body of evidence suggests that acute viral vertigo syndrome is viral, that the most likely viruses to do this are herpes family viruses, and that recurrent and chronic vestibular neuritis may benefit from use of antivirals.

• #22 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  The initial treatment for viral labyrinthitis consists of bed rest and hydration. Most patients can be treated on an outpatient basis. However, they should be cautioned to seek further medical care for worsening symptoms, especially neurologic symptoms (eg, diplopia, slurred speech, gait disturbances, localized weakness or numbness). Patients with severe nausea and vomiting may benefit from intravenous (IV) fluid and antiemetic medications. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Treatment of suppurative labyrinthitis is aimed at eradicating the underlying infection, providing supportive care to the patient, draining middle ear effusions or mastoid infections, and preventing the spread of infection. […] In cases of labyrinthitis resulting from otitis media, perform a myringotomy and evacuate the effusion. A ventilation tube also may be indicated. Middle ear effusion should be sent for microscopic evaluation, as well as culture and sensitivity.

• #23 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #24 Labyrinthitis – ENT Health

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

  Labyrinthitis is a self-limiting illness that usually gets better in several weeks. […] Patients with substantial balance issues may benefit from physical therapy, specifically vestibular physical therapy. […] Treating most cases of labyrinthitis includes observation, bed rest, and hydration. Steroids, such as prednisone, are typically prescribed to minimize inner ear inflammation. […] The treatment of bacterial labyrinthitis is to control the primary infection, which is usually a middle ear infection. This may require antibiotics, placement of an ear tube, or more advanced ear surgery. […] Treatment for autoimmune labyrinthitis addresses the underlying autoimmune condition with steroids or other immune modulating medications usually directed by the rheumatologist. […] 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. […] Vestibular therapy and balance exercises help many patients regain their balance.

• #25 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Regarding specific drug therapy, steroid therapy has been reported to relieve dizziness and promote vestibular compensation in vestibular neuritis; methylprednisolone is much more effective than placebo in reducing vertiginous symptoms in patients with acute vestibular vertigo. […] In vestibular rehabilitation therapy, the goals are to improve vertigo, gaze stability, postural stability, and daily living activities through vestibular compensation and central neuroplasticity. […] Vestibular rehabilitation exercises are mainly divided into generalized and customized vestibular exercises. […] Vestibular exercises significantly hasten vestibulospinal compensation in patients with acute vestibular neuritis. […] The persistent imbalance that some patients experience after acute vestibular neuritis may be due to many factors, including inadequate central compensation, incomplete peripheral recovery, and psychophysiological and psychological features.

• #26 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #27 Vestibular neuritis (VN) and labyrinthitis

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

  Acute labyrinthitis is treated with the same medications as vestibular neuritis, plus an antibiotic such as amoxicillin if there is evidence for a middle ear infection (otitis media), such as ear pain and an abnormal ear examination suggesting fluid, redness or pus behind the ear drum. Occasionally, especially for persons whose nausea and vomiting cannot be controlled, an admission to the hospital is made to treat dehydration with intravenous fluids. Generally admission is brief, just long enough to rehydrate the patient and start them on an effective medication to prevent vomiting. […] Steroids (prednisone, methylprednisolone or decadron) were previously suggested, but no longer are „standard of care”. Strupp and others (2004) reported that steroids (methylprednisolone for 3 weeks) significantly improved the recovery of peripheral vestibular function in patients with vestibular neuritis, while valacyclovir did not. However, several meta-analyses concluded that all studies suggesting improvement had significant methodological bias, and that there is currently insufficient evidence to recommend use of steroids for treatment of vestibular neuritis (Fishman et al, 2011; Leong et al, 2021; Wegner et al, 2012). Furthermore, Yoo et al (2017) studied 29 patients treated with methylprednisolone and found that „In this prospective RCT, methylprednisolone had no additional benefit in patients with VN who underwent vestibular exercises and received a Ginkgo biloba”. This study seems a bit underpowered to us, but still it suggests that steroids are not very helpful.

• #28 Vestibular Neuritis: Symptoms, Causes & Treatment

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

  Vestibular neuritis is an inner ear disorder that causes symptoms such as sudden, severe vertigo, dizziness, balance problems, nausea and vomiting. Treatment typically involves managing symptoms or taking antiviral medications. […] The main goal of vestibular neuritis treatment is to manage your symptoms. To do this, your healthcare provider may recommend: Medications (antivirals and drugs to treat nausea, dizziness and inflammation). […] Your healthcare provider may use a variety of medications to ease your vestibular neuritis symptoms, such as: Anti-nausea medications, Drugs to reduce dizziness, Drugs to reduce inflammation, Antiviral medications. […] If balance and dizziness problems last longer than a few weeks, your healthcare provider may recommend vestibular rehabilitation therapy. The goal of this program is to retrain your brain to adapt to the changes you experience.

• #29 Labyrinthitis and vestibular neuritis

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

  Labyrinthitis or vestibular neuritis usually gets better on its own. But there are things you can do to ease the symptoms. […] 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.

• #30 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Regarding specific drug therapy, steroid therapy has been reported to relieve dizziness and promote vestibular compensation in vestibular neuritis; methylprednisolone is much more effective than placebo in reducing vertiginous symptoms in patients with acute vestibular vertigo. […] In vestibular rehabilitation therapy, the goals are to improve vertigo, gaze stability, postural stability, and daily living activities through vestibular compensation and central neuroplasticity. […] Vestibular rehabilitation exercises are mainly divided into generalized and customized vestibular exercises. […] Vestibular exercises significantly hasten vestibulospinal compensation in patients with acute vestibular neuritis. […] The persistent imbalance that some patients experience after acute vestibular neuritis may be due to many factors, including inadequate central compensation, incomplete peripheral recovery, and psychophysiological and psychological features.

• #31 Labyrinthitis and vestibular neuritis

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

  Labyrinthitis or vestibular neuritis usually gets better on its own. But there are things you can do to ease the symptoms. […] 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.

• #32 Labyrinthitis – Wikipedia

  https://en.wikipedia.org/wiki/Labyrinthitis

  Vestibular rehabilitation therapy is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, neuroplasticity, and compensation. Vestibular neuritis rehabilitation is an effective and safe management to improve symptoms. The vestibular neuritis rehabilitation can improve symptoms or resolve the symptoms which is dependent on each individual. […] Rehabilitation strategies most commonly used are: Gaze stability exercises moving the head from side to side while fixated on a stationary object (aimed at assisting the eye to fixate during head rotation without the input from the lost canal vestibulo-ocular reflex). An advanced progression of this exercise would be walking in a straight line while looking side to side by turning the head. Habituation exercises movements designed to provoke symptoms and subsequently reduce the negative vestibular response upon repetition. Examples of these include BrandtDaroff exercises. Functional retraining including postural control, relaxation, and balance training.

• #33 Labyrinthitis – Wikipedia

  https://en.wikipedia.org/wiki/Labyrinthitis

  Vestibular rehabilitation therapy is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, neuroplasticity, and compensation. Vestibular neuritis rehabilitation is an effective and safe management to improve symptoms. The vestibular neuritis rehabilitation can improve symptoms or resolve the symptoms which is dependent on each individual. […] Rehabilitation strategies most commonly used are: Gaze stability exercises moving the head from side to side while fixated on a stationary object (aimed at assisting the eye to fixate during head rotation without the input from the lost canal vestibulo-ocular reflex). An advanced progression of this exercise would be walking in a straight line while looking side to side by turning the head. Habituation exercises movements designed to provoke symptoms and subsequently reduce the negative vestibular response upon repetition. Examples of these include BrandtDaroff exercises. Functional retraining including postural control, relaxation, and balance training.

• #34 Vestibular Neuritis & Labyrinthitis Treatment Melbourne

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

  Our physiotherapists tailor exercises based on your requirements and goals. This can involve a program including aspects such as: Gaze stability exercises, Habituation exercises, Balance exercises. By providing exercises designed to stabilise vision, desensitise the body to movement, and help restore balance, your physio will help you work towards relieving your symptoms and getting back to your normal self. By recalibrating and retraining your vestibular system, the normal processes that help to maintain your balance and movement can be reinstated.

• #35 Labyrinthitis – Wikipedia

  https://en.wikipedia.org/wiki/Labyrinthitis

  Vestibular rehabilitation therapy is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, neuroplasticity, and compensation. Vestibular neuritis rehabilitation is an effective and safe management to improve symptoms. The vestibular neuritis rehabilitation can improve symptoms or resolve the symptoms which is dependent on each individual. […] Rehabilitation strategies most commonly used are: Gaze stability exercises moving the head from side to side while fixated on a stationary object (aimed at assisting the eye to fixate during head rotation without the input from the lost canal vestibulo-ocular reflex). An advanced progression of this exercise would be walking in a straight line while looking side to side by turning the head. Habituation exercises movements designed to provoke symptoms and subsequently reduce the negative vestibular response upon repetition. Examples of these include BrandtDaroff exercises. Functional retraining including postural control, relaxation, and balance training.

• #36 Labyrinthitis/Vestibular Neuritis – Otological Disorders for Occupational Therapy

  https://www.picmonic.com/pathways/occupational-therapy/courses/standard/neuromuscular-nervous-systems-8044/otological-disorders-31320/labyrinthitisvestibular-neuritis_13941

  Physical therapists will often target improving balance and posture to help reduce fall risk in patients with Labyrinthitis/Vestibular Neuritis. These exercises aim to aid patients in maintaining balance with work and personal-related activities, including things such as balancing on different types of terrain or surfaces. […] Gait training involves careful analysis and correction of gait patterns to aid in the compensation of the impaired vestibular system. Physical therapists may focus on strengthening the trunk and core muscles to aid in postural stability and maintain an upright stance during acute vestibular attacks such as with Meneires Disease. […] Habituation exercises include maneuvers such as the Epley, Brandt-Daroff, and Dix-Hallpike, which aim to gradually desensitize patients to symptoms such as vertigo and dizziness. In these exercises, the physical therapist may put the patient in positions that elicit symptoms and then cease the movement of the patient temporarily to allow for the symptoms to subside.

• #37 Labyrinthitis: Help and Hope for Patient Patty Crutcher | WakeMed

  https://www.wakemed.org/blog/labyrinthitis-help-and-hope-patient-patty-crutcher

  Patty scheduled an appointment with WakeMed Primary Care physician Rhoda Chang, MD, who diagnosed her with labyrinthitis. Dr. Chang prescribed a steroid dose pack and then referred Patty to an ear nose and throat (ENT) specialist, where she learned she’d lost 30 percent of her left-side hearing function and 40 percent of her left-side balance function due to the prolonged, untreated condition. She was referred to WakeMed Physical Therapy, where she met vestibular specialist Ann Pearce, PT, DPT for vestibular rehabilitation therapy. […] Ann Pearce explains, „Our goal for Patty’s physical therapy was to help her get back to as many of her activities as possible without feeling dizzy. Initially, this involved walking on greenways and as she got better, we aimed for her to return to running. The interventions we used included gaze stabilization exercises to improve her ability to focus on stationary object while moving her head, habituation exercises to decrease her dizziness, sensory balance exercises to help her feel where she was in space and dynamic balance exercises to support her in moving more quickly without losing her balance or getting dizzy.”

• #38 What is the treatment for labyrinthitis?

  https://www.mymed.com/diseases-conditions/inner-ear-infection-labyrinthitis-vestibular-neuritis/what-is-the-treatment-for-labyrinthitis

  This exercise-based form of treatment is designed to help ease the symptoms of a chronic inner ear infection, particularly those of vertigo and dizziness, the exercise program does this by promoting vestibular (i.e. relating to the inner ear) adaptation, as well as substitution. […] VRT aids in retraining the nervous system and brain in order to compensate for any abnormal symptoms and signs stemming from the vestibular system. […] VRT is typically supervised by a specialist such as a physiotherapist. […] A physiotherapist is a qualified expert in treating injury, disease or deformity through utilising physical methods such as exercise, massage and even heat treatment. […] He or she will make use of a range of different exercises designed to aid in the below ways: […] Improvement of hand-eye co-ordination enhancing the stability of one’s gaze […] Simulation of dizziness in order to allow the brain to adjust to the specific disruptive signals that are sent to it from the vestibular system and train it to ignore these signals. […] Improvement of walking ability and balance […] Improvement of fitness and strength.

• #39 Vestibular Neuritis: Symptoms, Causes, Diagnosis, and Treatment

  https://www.healthline.com/health/vestibular-neuritis

  For vestibular neuritis caused by an underlying infection, you’ll likely need antibiotics or antiviral medications to treat the infection. There’s no standard treatment for vestibular neuritis itself, but a few things might help to reduce your symptoms as you recover. […] If your symptoms aren’t getting any better after a few weeks, you may need vestibular rehabilitation therapy. This involves doing gentle movements, such as Brandt-Daroff exercises, to help your brain adjust to changes in your balance. When you first start doing these exercises, you might feel like your symptoms are getting worse, which is normal. […] If you continue to have spells of dizziness and vertigo after several months, medication and physical therapy may be helpful.

• #40 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Regarding specific drug therapy, steroid therapy has been reported to relieve dizziness and promote vestibular compensation in vestibular neuritis; methylprednisolone is much more effective than placebo in reducing vertiginous symptoms in patients with acute vestibular vertigo. […] In vestibular rehabilitation therapy, the goals are to improve vertigo, gaze stability, postural stability, and daily living activities through vestibular compensation and central neuroplasticity. […] Vestibular rehabilitation exercises are mainly divided into generalized and customized vestibular exercises. […] Vestibular exercises significantly hasten vestibulospinal compensation in patients with acute vestibular neuritis. […] The persistent imbalance that some patients experience after acute vestibular neuritis may be due to many factors, including inadequate central compensation, incomplete peripheral recovery, and psychophysiological and psychological features.

• #41 Treatment of Vertigo | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/0315/p1115.html

  A retrospective case series assessed the efficacy of physical therapy in patients who had vestibular and balance disorders with or without a history of migraine. Both groups showed significant alleviation of dizziness and improvement of balance and gait. Vestibular exercises also have been shown to improve postural control during the first month after acute unilateral vestibular lesions resulting from vestibular neuronitis.

• #42 Vestibular Neuritis and Labyrinthitis | NHS Lanarkshire

  https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy/vestibular-physiotherapy/vestibular-neuritis-and-labyrinthitis/

  Your doctor may give you medication initially to settle the symptoms. It is important to move around as normally as soon as possible and move your head to allow the system to recover. Vestibular exercises will help your system return to normal and you to return to your normal activities. The earlier you do this the quicker your system will recover. […] Many people get into the habit of avoiding positions and situations that trigger their symptoms, these habits will slow down recovery and lead to additional problems. […] Once your balance improves, you should resume regular exercise which will help your balance system recover slowly. During your normal day to day activities and during exercise, you might think that keeping your head in a fixed position will help prevent dizziness but doing this actually does more harm than good. It is very important to move as naturally as possible to allow your balance system to return to normal. […] Anti-Vertigo and Anti-Sickness Medication These tablets can help during a bad attack of vertigo but we strongly discourage you from taking these medications on a regular basis especially for prolonged periods as they can cause side effects and prevent you from recovering from the original problem.

• #43 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

  When Vestibular Rehabilitation commences, it is usually recommended that vestibular-suppressant medications be discontinued, as they can interfere with the ability of the brain to adjust to the exercises. […] If permanent damage to hearing has occurred, hearing aids may be useful. Treatment for tinnitus may also be considered, if prominent.

• #44 Vestibular Neuritis and Labyrinthitis | NHS Lanarkshire

  https://www.nhslanarkshire.scot.nhs.uk/services/physiotherapy/vestibular-physiotherapy/vestibular-neuritis-and-labyrinthitis/

  Your doctor may give you medication initially to settle the symptoms. It is important to move around as normally as soon as possible and move your head to allow the system to recover. Vestibular exercises will help your system return to normal and you to return to your normal activities. The earlier you do this the quicker your system will recover. […] Many people get into the habit of avoiding positions and situations that trigger their symptoms, these habits will slow down recovery and lead to additional problems. […] Once your balance improves, you should resume regular exercise which will help your balance system recover slowly. During your normal day to day activities and during exercise, you might think that keeping your head in a fixed position will help prevent dizziness but doing this actually does more harm than good. It is very important to move as naturally as possible to allow your balance system to return to normal. […] Anti-Vertigo and Anti-Sickness Medication These tablets can help during a bad attack of vertigo but we strongly discourage you from taking these medications on a regular basis especially for prolonged periods as they can cause side effects and prevent you from recovering from the original problem.

• #45 Vestibular Neuritis: Causes, Symptoms, And Treatment | BenchMark Physical Therapy

  https://www.benchmarkpt.com/blog/vestibular-neuritis-causes-symptoms-and-treatment/

  Vestibular neuritis treatment typically involves medication and physical therapy. Your healthcare provider may prescribe several medications to treat the underlying virus or infection and ease nausea, dizziness, and inflammation. […] Vestibular rehabilitation therapy (VRT) consists of exercises and activities to help patients with vestibular disorders manage their symptoms. […] This form of physical therapy specifically addresses balance and stability problems, incorporating safe and gentle movements to help the brain adjust to balance changes. […] One clinical study found that weekly physical therapist-guided interventions for at least six months are recommended to achieve optimal results. […] Although it’s best to seek treatment at the early onset of dizziness, vestibular therapy can help you achieve some level of improvement, no matter how long symptoms have been present.

• #46 Labyrinthitis – Wikipedia

  https://en.wikipedia.org/wiki/Labyrinthitis

  One study found that patients who believed their illness was out of their control showed the slowest progression to full recovery, long after the initial vestibular injury had healed. The study revealed that the patient who compensated well was one who, at the psychological level, was not afraid of the symptoms and had some positive control over them. Notably, a reduction in negative beliefs over time was greater in those patients treated with rehabilitation than in those untreated. „Of utmost importance, baseline beliefs were the only significant predictor of change in a handicap at 6 months follow-up.” […] Vestibular neuritis is generally a self-limiting disease. Treatment with drugs is neither effective nor necessary. The effect of glucocorticoids has been studied, but they have not been found to significantly affect long-term outcome. Symptomatic treatment with antihistaminics such as cinnarizine, however, can be used to suppress the symptoms of vestibular neuritis while it spontaneously regresses. Prochlorperazine is another commonly prescribed medication to help alleviate the symptoms of vertigo and nausea. […] Because mood disorders can hamper recovery from labyrinthitis, treatment may also include any co-occurring anxiety disorder or depression. Severe anxiety episodes are usually addressed by short-term benzodiazepine therapy.

• #47 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  The initial treatment for viral labyrinthitis consists of bed rest and hydration. Most patients can be treated on an outpatient basis. However, they should be cautioned to seek further medical care for worsening symptoms, especially neurologic symptoms (eg, diplopia, slurred speech, gait disturbances, localized weakness or numbness). Patients with severe nausea and vomiting may benefit from intravenous (IV) fluid and antiemetic medications. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Treatment of suppurative labyrinthitis is aimed at eradicating the underlying infection, providing supportive care to the patient, draining middle ear effusions or mastoid infections, and preventing the spread of infection. […] In cases of labyrinthitis resulting from otitis media, perform a myringotomy and evacuate the effusion. A ventilation tube also may be indicated. Middle ear effusion should be sent for microscopic evaluation, as well as culture and sensitivity.

• #48 Labyrinthitis – ENT Health

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

  Labyrinthitis is a self-limiting illness that usually gets better in several weeks. […] Patients with substantial balance issues may benefit from physical therapy, specifically vestibular physical therapy. […] Treating most cases of labyrinthitis includes observation, bed rest, and hydration. Steroids, such as prednisone, are typically prescribed to minimize inner ear inflammation. […] The treatment of bacterial labyrinthitis is to control the primary infection, which is usually a middle ear infection. This may require antibiotics, placement of an ear tube, or more advanced ear surgery. […] Treatment for autoimmune labyrinthitis addresses the underlying autoimmune condition with steroids or other immune modulating medications usually directed by the rheumatologist. […] 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. […] Vestibular therapy and balance exercises help many patients regain their balance.

• #49 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  The initial treatment for viral labyrinthitis consists of bed rest and hydration. Most patients can be treated on an outpatient basis. However, they should be cautioned to seek further medical care for worsening symptoms, especially neurologic symptoms (eg, diplopia, slurred speech, gait disturbances, localized weakness or numbness). Patients with severe nausea and vomiting may benefit from intravenous (IV) fluid and antiemetic medications. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Treatment of suppurative labyrinthitis is aimed at eradicating the underlying infection, providing supportive care to the patient, draining middle ear effusions or mastoid infections, and preventing the spread of infection. […] In cases of labyrinthitis resulting from otitis media, perform a myringotomy and evacuate the effusion. A ventilation tube also may be indicated. Middle ear effusion should be sent for microscopic evaluation, as well as culture and sensitivity.

• #50 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery. […] Common labyrinthitis medications include: Antivirals (if a virus caused it), Antibiotics (if a bacterium caused it), Corticosteroids to reduce nerve inflammation, Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine). […] If your symptoms dont improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance. […] You can also try home remedies to ease labyrinthitis symptoms: Apply a warm compress over your ear, Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear), Limit alcohol intake, Try stress management techniques, like mindfulness or meditation.

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

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

  The treatment of labyrinthitis and vestibular neuritis is different in the early and later stages. […] Early treatment: (first week of symptoms) Supportive care along with medication will help symptoms including anti-nausea medication and vestibular suppressant medication. Stay hydrated while avoiding alcohol, tobacco and caffeine. Antibiotics or antivirals may be given if an infection is identified. Avoiding quick movements. If hearing loss is detected, oral steroids or steroid ear injections may be recommended. […] Later treatment: (after first week of symptoms) Ending vestibular suppressant medication use. Slowly resume normal activities. Your doctor may recommend a course of vestibular physical therapy or home exercises which can help the balance system recover. Following these care tips and the advice of your doctor, most individuals see symptoms clear up within three to six weeks.

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

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

  In vestibular neuritis and labyrinthitis symptoms resolve without treatment after several weeks. […] Anti-nausea medications may be prescribed to help with initial symptoms. […] On some occasions, medications may be prescribed by your otolaryngologists if necessary. […] If vertigo does not resolve after several weeks, vestibular rehabilitation therapy by specially trained physical therapists may be recommended to help retrain the brain to adapt and compensate for the incorrect signals. […] In labyrinthitis hearing loss may or may not improve. […] If hearing loss does not improve, hearing technology may be recommended.

• #53 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. […] Treatment includes steroids, medications for symptom relief and vestibular rehabilitation therapy (VRT) for long-term recovery. […] Most patients recover fully, but some experience lingering dizziness or imbalance requiring ongoing therapy. […] Vestibular Rehabilitation Therapy (VRT): Custom exercises like gaze stabilization and balance training to promote brain adaptation. […] Vestibular Rehabilitation Therapy for prolonged dizziness. […] Hearing aids if hearing loss persists. […] If there is complete loss in the affected ear, an emergency cochlear implant should be considered. This should be done very quickly before the inner ear ossified (gets filled with bone) from the inflammation. […] Chronic dizziness affects up to 10% (sometimes more) of patients, requiring extended VRT. […] Bacterial cases may result in permanent hearing loss if treatment is delayed.

• #54 Labyrinthitis – ENT Health

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

  Labyrinthitis is a self-limiting illness that usually gets better in several weeks. […] Patients with substantial balance issues may benefit from physical therapy, specifically vestibular physical therapy. […] Treating most cases of labyrinthitis includes observation, bed rest, and hydration. Steroids, such as prednisone, are typically prescribed to minimize inner ear inflammation. […] The treatment of bacterial labyrinthitis is to control the primary infection, which is usually a middle ear infection. This may require antibiotics, placement of an ear tube, or more advanced ear surgery. […] Treatment for autoimmune labyrinthitis addresses the underlying autoimmune condition with steroids or other immune modulating medications usually directed by the rheumatologist. […] 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. […] Vestibular therapy and balance exercises help many patients regain their balance.

• #55 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  The initial treatment for viral labyrinthitis consists of bed rest and hydration. Most patients can be treated on an outpatient basis. However, they should be cautioned to seek further medical care for worsening symptoms, especially neurologic symptoms (eg, diplopia, slurred speech, gait disturbances, localized weakness or numbness). Patients with severe nausea and vomiting may benefit from intravenous (IV) fluid and antiemetic medications. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Treatment of suppurative labyrinthitis is aimed at eradicating the underlying infection, providing supportive care to the patient, draining middle ear effusions or mastoid infections, and preventing the spread of infection. […] In cases of labyrinthitis resulting from otitis media, perform a myringotomy and evacuate the effusion. A ventilation tube also may be indicated. Middle ear effusion should be sent for microscopic evaluation, as well as culture and sensitivity.

• #56 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #57 Labyrinthitis: Causes, Symptoms, Treatment, and More

  https://www.verywellhealth.com/what-is-labrynthitis-and-vestibular-neuritis-1191935

  Vestibular rehabilitation may be useful if your symptoms persist for a long time or become chronic. Vestibular rehabilitation is a form of physical therapy that works to retrain your mind and body to compensate for your vestibular imbalance. […] In severe cases, nausea and vomiting may result in dehydration. In fact, you might need hospitalization, intravenous (IV) fluid replacement, and monitoring of your vital signs (pulse and respiration). Once your labyrinthitis resolves, nausea and vomiting should resolve as well.

• #58 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Very rarely, you might need a labyrinthectomy. During this procedure, a surgeon removes your vestibular end organs (the thin, membrane-like parts of your inner ear). […] Providers dont recommend labyrinthitis surgery very often. Its a last resort treatment for people with vertigo and significant hearing loss in the affected ear.

• #59 Vestibular neuritis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vestibular-neuritis/

  Corticosteroids (e.g., prednisone) […] Not routinely recommended […] There is evidence they improve recovery at the one-month mark, but long-term benefits are uncertain. […] If considered, they should be started within 72 hours of symptom onset. […] Antiviral therapy: not routinely recommended. […] Vestibular rehabilitation therapy: facilitates central vestibular compensation and accelerates recovery. […] Indication: consider in patients with refractory symptoms. […] Procedures: Chemical labyrinthectomy: transtympanic gentamicin infusion […] Surgery: vestibular neurectomy or labyrinthectomy. […] Spontaneous recovery or central vestibular compensation and habituation within a few weeks is common (good prognosis). […] Vestibular rehabilitation can speed up recovery.

• #60 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Very rarely, you might need a labyrinthectomy. During this procedure, a surgeon removes your vestibular end organs (the thin, membrane-like parts of your inner ear). […] Providers dont recommend labyrinthitis surgery very often. Its a last resort treatment for people with vertigo and significant hearing loss in the affected ear.

• #61 Labyrinthitis: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/22032-labyrinthitis

  Labyrinthitis treatment depends on the severity of your condition. Healthcare providers may recommend medications, physical therapy, home remedies or a combination of the three. In very rare cases, labyrinthitis may require surgery. […] Common labyrinthitis medications include: Antivirals (if a virus caused it), Antibiotics (if a bacterium caused it), Corticosteroids to reduce nerve inflammation, Drugs to control dizziness and nausea (like diphenhydramine or fexofenadine). […] If your symptoms dont improve in a few weeks, your healthcare provider will likely recommend vestibular rehabilitation therapy for labyrinthitis. This involves doing certain exercises to manage dizziness and imbalance. […] You can also try home remedies to ease labyrinthitis symptoms: Apply a warm compress over your ear, Gargle with warm salt water to help clear your eustachian tube (a small passage that connects your throat and middle ear), Limit alcohol intake, Try stress management techniques, like mindfulness or meditation.

• #62 Labyrinthitis Causes, Ear Symptoms, Treatments & Medications

  https://www.medicinenet.com/labyrinthitis_inner_ear_inflammation/article.htm

  What natural or home remedies treat labyrinthitis symptoms? Home remedies cannot treat or cure labyrinthitis, but they may help relieve symptoms. Using a warm compress over the ear may ease the pain. Stand or keep your head upright. Sitting can help drain the ear. A saltwater gargle may help clear Eustachian tubes, and soothe a sore throat that may accompany labyrinthitis. Do not smoke and limit alcohol intake. Use stress management techniques to control emotional and psychological stress, as stress can worsen symptoms. Over-the-counter (OTC) medications, for example, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may relieve pain. Do not give children and teenagers aspirin as this has been linked with a serious condition called Reye’s syndrome. If your doctor approves, OTC eardrops may be used to relieve pain. Eardrops should not be used in children with tympanostomy tubes (ear tubes) unless specifically prescribed by your child’s pediatrician. AVOID cold and cough medicines in young children, as these can have dangerous side effects. Some natural remedies and alternative treatments are touted as treatments or cures for labyrinthitis, including garlic oil or tea tree oil ear drops, apple cider vinegar, basil, olive oil, and hydrogen peroxide. Scientific studies do not show any of these to be effective. Some chiropractors also claim to be able to treat labyrinthitis with manipulation; however, there currently are no studies that show chiropractic treatment to be effective for labyrinthitis. Talk to your doctor before using any home remedies.

• #63 Labyrinthitis: Causes, Symptoms, Treatment, Diagnosis & More

  https://www.healthline.com/health/labyrinthitis

  The treatment for labyrinthitis usually involves using medications to control your symptoms. Most people find relief from symptoms within one to three weeks and achieve full recovery in a month or two. […] Symptoms can be relieved with medications, including: prescription antihistamines, such as desloratadine (Clarinex); medications that can reduce dizziness and nausea, such as meclizine (Antivert); sedatives, such as diazepam (Valium); corticosteroids, such as prednisone; over-the-counter antihistamines, such as fexofenadine (Allegra), diphenhydramine (Benadryl), or loratadine (Claritin). […] If you have an active infection, your doctor will probably prescribe antibiotics. […] In addition to taking medications, there are several techniques you can use to relieve vertigo: Avoid quick changes in position or sudden movements. Sit still during a vertigo attack. Get up slowly from a lying down or seated position. Avoid television, computer screens, and bright or flashing lights during a vertigo attack. If vertigo occurs while you’re in bed, try sitting up in a chair and keeping your head still. Low lighting is better for your symptoms than darkness or bright lights. […] If your vertigo continues for a long time, physical and occupational therapists can teach you exercises to help improve balance.

• #64 Vestibular Neuritis & Labyrinthitis ENT Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/dizziness-balance/vestibular-neuritis/

  In rare instances, if the cause is a bacterial infection, your doctor will give you antibiotics, but most cases are caused by viral infections, which cannot be cured with antibiotics. Initial treatment may involve steroid medicine in attempt to shorten the duration and severity of symptoms. Medication for the dizziness and nausea can also be used. In some cases where imbalance persists for a long period of time, a course of vestibular therapy (balance therapy) may help resolve the imbalance more rapidly. […] In addition to taking medications, there are multiple techniques you can use to relieve vertigo symptoms. Balance exercises consisting of simple head movements and keeping your balance while standing and sitting can help reduce symptoms of vertigo. Vertigo usually gets better as your body adjusts to what is happening (compensation). Medicines like antihistamines can help your other symptoms, but they may make it take longer for vertigo to go away for good. If your vertigo persists for a long time, physical and occupational therapists can teach you certain exercises that will help improve your balance. In most cases, vestibular neuritis/labyrinthitis will improve with time. This can take weeks to months.

• #65 Labyrinthitis – Wikipedia

  https://en.wikipedia.org/wiki/Labyrinthitis

  One study found that patients who believed their illness was out of their control showed the slowest progression to full recovery, long after the initial vestibular injury had healed. The study revealed that the patient who compensated well was one who, at the psychological level, was not afraid of the symptoms and had some positive control over them. Notably, a reduction in negative beliefs over time was greater in those patients treated with rehabilitation than in those untreated. „Of utmost importance, baseline beliefs were the only significant predictor of change in a handicap at 6 months follow-up.” […] Vestibular neuritis is generally a self-limiting disease. Treatment with drugs is neither effective nor necessary. The effect of glucocorticoids has been studied, but they have not been found to significantly affect long-term outcome. Symptomatic treatment with antihistaminics such as cinnarizine, however, can be used to suppress the symptoms of vestibular neuritis while it spontaneously regresses. Prochlorperazine is another commonly prescribed medication to help alleviate the symptoms of vertigo and nausea. […] Because mood disorders can hamper recovery from labyrinthitis, treatment may also include any co-occurring anxiety disorder or depression. Severe anxiety episodes are usually addressed by short-term benzodiazepine therapy.

• #66 Vestibular neuritis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vestibular-neuritis/

  Corticosteroids (e.g., prednisone) […] Not routinely recommended […] There is evidence they improve recovery at the one-month mark, but long-term benefits are uncertain. […] If considered, they should be started within 72 hours of symptom onset. […] Antiviral therapy: not routinely recommended. […] Vestibular rehabilitation therapy: facilitates central vestibular compensation and accelerates recovery. […] Indication: consider in patients with refractory symptoms. […] Procedures: Chemical labyrinthectomy: transtympanic gentamicin infusion […] Surgery: vestibular neurectomy or labyrinthectomy. […] Spontaneous recovery or central vestibular compensation and habituation within a few weeks is common (good prognosis). […] Vestibular rehabilitation can speed up recovery.

• #67 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. […] Treatment includes steroids, medications for symptom relief and vestibular rehabilitation therapy (VRT) for long-term recovery. […] Most patients recover fully, but some experience lingering dizziness or imbalance requiring ongoing therapy. […] Vestibular Rehabilitation Therapy (VRT): Custom exercises like gaze stabilization and balance training to promote brain adaptation. […] Vestibular Rehabilitation Therapy for prolonged dizziness. […] Hearing aids if hearing loss persists. […] If there is complete loss in the affected ear, an emergency cochlear implant should be considered. This should be done very quickly before the inner ear ossified (gets filled with bone) from the inflammation. […] Chronic dizziness affects up to 10% (sometimes more) of patients, requiring extended VRT. […] Bacterial cases may result in permanent hearing loss if treatment is delayed.

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

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

  In vestibular neuritis and labyrinthitis symptoms resolve without treatment after several weeks. […] Anti-nausea medications may be prescribed to help with initial symptoms. […] On some occasions, medications may be prescribed by your otolaryngologists if necessary. […] If vertigo does not resolve after several weeks, vestibular rehabilitation therapy by specially trained physical therapists may be recommended to help retrain the brain to adapt and compensate for the incorrect signals. […] In labyrinthitis hearing loss may or may not improve. […] If hearing loss does not improve, hearing technology may be recommended.

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

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

  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. […] 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. […] Vestibular rehabilitation exercises facilitate this compensation. […] After the evaluation, personalized vestibular rehabilitation exercises are developed. Most of these exercises can be performed independently at home, although the therapist will continue to monitor and modify the exercises. […] It is usually recommended that vestibular-suppressant medications be discontinued during this exercise therapy, because the drugs interfere with the ability of the brain to achieve compensation.

• #70 Current diagnosis and treatment of vestibular neuritis: a narrative review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8913909/

  Vestibular neuritis is characterized by acute spontaneous vertigo without hearing loss and is the third most common peripheral vestibular disorder, after benign paroxysmal positional vertigo and Meniere disease. […] Therefore, various treatments have been used for vestibular neuritis, such as corticosteroids, antivirals, and vestibular rehabilitation exercises. […] Various treatments for vestibular neuritis have been reported, which can be largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. […] Symptomatic therapy reduces anxiety by explaining in detail the cause, treatment, and prognosis of vestibular neuritis in patients, and provides psychological support by explaining that daily life is possible in a short period of time. […] Vestibular suppressants are widely used because they are effective against dizziness, nausea, and vomiting.

• #71 Labyrinthitis Treatment & Management: Approach Considerations, Pharmacologic Therapy, Outpatient Care

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

  Most patients with labyrinthitis can be evaluated and treated in the emergency department and then discharged. Some patients with intractable vertigo and vomiting may require admission. […] Diazepam or other benzodiazepines are occasionally helpful as a vestibular suppressant. A short course of oral corticosteroids may be helpful. Currently, the role of antiviral therapy is not established. […] In a randomized, controlled trial by Strupp et al, steroids (methylprednisolone) were found to be more effective than antiviral agents (valacyclovir) for recovery of peripheral vestibular function in patients with vestibular neuritis. This may also apply to the treatment of viral labyrinthitis. […] For bacterial labyrinthitis, antibiotic treatment is selected based on culture and sensitivity results. Antibiotic treatment should consist of broad-spectrum antibiotic or combination therapy with CNS penetration until culture results are available. Treat the vertigo symptomatically as indicated. […] Patients with persistent vestibular symptoms may be candidates for vestibular rehabilitation. For many patients with chronic vertigo due to a peripheral vestibular etiology, a simple home program of vestibular habituation head movement exercises reduces symptoms of imbalance during stance and gait.

• #72 Labyrinthitis – Balance & Dizziness Canada

  https://balanceanddizziness.org/disorders/vestibular-disorders/labyrinthitis/

  You may also be given medication to treat the infection that is causing labyrinthitis. […] If this happens, vestibular rehabilitation may help. […] Vestibular rehabilitation is a type of exercise-based therapy. Its goal is to help your brain relearn how to balance and how to respond to signals from the vestibular and visual systems. […] Remember that vestibular rehabilitation takes time and effort. Your therapist will teach you the exercises you need to do, but you are the one who needs to do them on schedule.

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