Labyrinthitis

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Some sources consider vestibular neuritis and labyrinthitis to be the same thing (some differentiate based on auditory symptoms)

Background

  • Infection of cochlear and vestibular apparatus (from middle ear via round/oval windows)
  • Acute suppurative labyrinthitis is only cause of peripheral vertigo requiring urgent treatment
  • Some sources consider Vestibular Neuritis and Labyrinthitis to be the same thing
    • Some differentiate based on auditory symptoms

Clinical Features

  • Peripheral vertigo + hearing loss + middle ear findings
    • Severity depends on type of labyrinthitis:
      • Acute suppurative labyrinthitis
        • Caused by extension of infection from otitis media, meningitis, mastoiditis
        • Signs of toxicity
      • Serous labyrinthitis

Differential Diagnosis

Vertigo

Evaluation

See Vertigo

Management

  • Suppurative form requires antibiotics
  • Prochlorperazine 10mg PO q6 PRN for nausea/vomiting
  • Lorazepam OR diazepam as vestibular depressant
  • Bed rest and hydration
  • Corticosteroids controversial especially in concomitant suppurative form

Disposition

  • Suppurative form require admission for definitive ENT treatment

See Also

References