Vestibular Neuritis and Labyrinthitis

These conditions are similar in that they are are disorders resulting from an infection that causes inflammation to the inner ear.  The infection is most commonly viral, but can sometimes be bacterial. This infection is different than a middle ear infection, which commonly causes ear pain. Common symptoms of a vestibular neuritis or labyrinthitis include: vertigo, dizziness, balance issues, and changes to vision and hearing.

Vestibular Neuritis

A vestibular neuritis is inflammation to the vestibular nerve, the connection between the brain and the inner ear. Symptoms of a vestibular neuritis can be mild or severe, ranging from subtle dizziness to significant room spinning vertigo, nausea, vomiting, imbalance and inability to stand up without assistance.

Labyrinthitis

A labyrinthitis is inflammation to the entire labyrinth, the inner ear organ responsible for hearing and balance. The same symptoms of a vestibular neuritis are present, in addition to tinnitus (ringing in the ears) or hearing loss.

Acute Phase

The acute phase of a vestibular neuritis or labyrinthitis is characterized by a sudden onset of the symptoms listed above, most commonly upon waking up in the morning. This phase can last a number of days to weeks depending on the severity of the infection and inflammation. Most people visit their doctor or the emergency room during this phase due to the severity of the symptoms. Medications to reduce the symptoms of dizziness are nausea are used during this phase.

Chronic Phase

After a number of days to weeks, the symptoms of vertigo and dizziness subside. However, some people are left with a chronic form of this disorder. Chronic symptoms are caused by permanent damage to the vestibular nerve. This is then termed a vestibular hypofunction (weakness). Symptoms of the chronic phase can include: mild dizziness or disorientation, imbalance, fatigue, and brain fog. Quick movements, being in a crowded or busy environment, driving, standing in the shower with the eyes closed, or walking through a grocery store are typical activities that provoke symptoms. Vestibular therapy is the treatment of choice for this stage.

What is Vestibular Therapy?

The basis of vestibular therapy stems from assessing the 3 balance systems. Your body uses 3 sensory systems to maintain your balance during all your usual daily activities. These sensory systems are your vision, somatosensory system and your vestibular system.

Vision:

You use your vision to detect how your moving through your environment. Your body can tell whether your static or in motion, how fast your going and the direction your are going in, just by processing visual information.

Somatosensory System:

Your somatosensory system, simply put, is your sense of touch. For example, being able to feel the floor underneath of your feet while you walk, sensing the position of your joints, and sensing your postural positioning. This system allows your body to understand how it is moving through space.

Vestibular system:

Your vestibular system is your internal gyroscope. It gives your body an understanding of how it is positioned in space, how fast your are moving and what direction your are going in. This system is weakened after a vestibular neuritis or labyrinthitis.

After having permanent damage to your vestibular system, your body must compensate by using your vision and somatosensory system more heavily to maintain your balance. Vestibular therapy helps promote this compensation.

Vestibular neuritis and Labyrinthitis are the second most common cause of dizziness that we see at FYZICAL Shady Grove. If you have recently experienced an episode of intense vertigo and are continuing to have symptoms of dizziness or imbalance, it may be beneficial to see a physical therapist and assess your need for vestibular therapy to help reduce your symptoms and get back to living your best life.