Also called “vestibular neuritis,” Labyrinthitis is presumed to be a viral infection of the inner ear, though nobody knows for sure the cause (see Diagram — Anatomy of the Ear).ย  At any rate, patients have ongoing vertigo, not just occurring with head movement lasting seconds (which would be diagnosed as BPPV – Benign Paroxysmal Positional Vertigo).ย  Acute Labyrinthitis lasts 2-3 days, though insecure balance may persist 1-2 months.

Vertigo means a sensation of movement in a single direction, either the person or the environment; it may be spinning, or feeling thrust, but isn’t simply wobbly or woozy.ย  Symptoms may include nausea and/or vomiting, and hearing loss or ringing in the ear on just one side.

The main diagnostic concern is to be sure it’s not a Stroke.ย  Patients having a stroke with vertigo usually have some other neurologic symptom as well, like double vision, slurred speech, hoarseness, trouble swallowing, or headache.ย  They may not be able to stand with their feet together.

Strokes usually occur in people with risk factors.ย  These include Age >50, Hypertension, Diabetes, Heart Diseases, and also diseases like Lupus, Sickle Cell Disease, and others.

Signs of Stroke with vertigo should be detectible by a good neurologic exam, which some generalist clinicians may not be so adept at.ย  They need to carefully examine all the cranial nerves, especially nerves 6-12, also cerebellar function in arms & legs, & perform a Romberg test with eyes both open & then closed [a patient should ask their provider if they’ve done all this].ย 

An 81-year-old friend of mine was misdiagnosed with “labyrinthitis”, & died of her stroke.ย  Nobody >50 should be told they have “labyrinthitis,” aka “vestibular neuritis,” without an MRI.ย  Never let anybody diagnose you with “Vertigo;” that’s just a synonym for โ€œroom spinningโ€ which you already know you have.ย  Insist on knowing why you have it, what’s the cause.

There are various medicines to make patients feel better until Labyrinthitis resolves on its own.  If symptoms have not begun to improve by the 4th day, question the diagnosis & seek care again.

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