| 🩺 Feature |
🎧 Labyrinthitis |
⚖️ Vestibular Neuritis |
| Definition |
Inflammation of the labyrinth (inner ear) affecting both hearing and balance. |
Inflammation of the vestibular nerve affecting balance only. |
| Common Causes |
- 🦠 Viral (e.g. HSV, influenza, adenovirus)
- 🧫 Bacterial (from otitis media or meningitis)
- 🤕 Trauma, allergy, ototoxic drugs (rare)
|
- 🦠 Viral (e.g. HSV, influenza)
- 🤕 Post-viral inflammation of the vestibular nerve
|
| Symptoms |
- 🌪️ Acute vertigo (hours–days)
- 🎧 Unilateral sensorineural hearing loss
- 🔔 Tinnitus
- 🤢 Nausea, vomiting
- 🚶♀️ Imbalance and gait unsteadiness
|
- 🌪️ Acute vertigo (hours–days)
- 🤢 Nausea, vomiting
- 🚶♂️ Imbalance
- ❌ No hearing loss or tinnitus
|
| Otoscopy / Hearing Tests |
- Normal tympanic membrane unless concurrent otitis media
- Sensorineural hearing loss on tuning fork or audiometry
- Positive Rinne and Weber lateralises to good ear
|
- Normal hearing
- Normal tuning fork tests
|
| Diagnosis |
- Clinical diagnosis (vertigo + hearing loss)
- Audiometry: confirms SNHL
- MRI brain/IAC if atypical features (exclude stroke or acoustic neuroma)
|
- Clinical diagnosis (vertigo without hearing loss)
- Head impulse test positive (peripheral vestibular lesion)
- MRI if central signs or persistent symptoms
|
| Treatment |
- 🎯 Treat cause: Antivirals or antibiotics if indicated
- 💊 Symptomatic:
– Prochlorperazine or Cyclizine (≤3 days)
– Ondansetron if severe vomiting
- 💉 Short course of oral corticosteroids (may aid recovery)
- 🚶♀️ Vestibular rehabilitation therapy (VRT)
- 🎧 Hearing may recover over weeks; counsel about safety (e.g. driving).
|
- 💊 Corticosteroids (early use may improve recovery)
- 🎯 Symptomatic relief as above
- 🚶♂️ VRT: critical for neuroplastic compensation
- ❌ Avoid prolonged vestibular suppressants - delay recovery
|
| Prognosis |
- ⏳ Recovery in 2–6 weeks; hearing often improves but may remain reduced.
- 🧭 Some develop chronic imbalance or anxiety-related dizziness.
|
- ⏳ Usually resolves fully in weeks; recurrent episodes are rare.
- 🧠 Brain compensation restores balance via central adaptation.
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