Labyrinthitis and vestibular neuritis

Expert reviewer, Mr Anil Banerjee, Ear, Nose and Throat Consultant
Next review due October 2023

Labyrinthitis and vestibular neuritis are conditions that cause inflammation of your inner ear, usually as a result of an infection. They can make you feel sick and dizzy, and cause problems with your balance. Labyrinthitis also affects your hearing.

What are labyrinthitis and vestibular neuritis?

Labyrinthitis and vestibular neuritis affect different parts of your inner ear. Your inner ear is made up of a system of fluid-filled tubes called the labyrinth. This includes your cochlea, which senses sound, and your vestibular system, which senses movement of your head and helps with balance. Your vestibular nerve passes through your inner ear, taking messages to your brain.

  • With vestibular neuritis, only your vestibular nerve is affected. This causes vertigo (the sensation that you, or things around you, are spinning), and problems with balance.
  • With labyrinthitis, your labyrinth is affected too, which causes hearing loss as well as problems with balance.

Labyrinthitis and vestibular neuritis can affect both adults and children, but they're most common between the ages of 30 and 60.

Causes of labyrinthitis and vestibular neuritis

There are various things that can cause labyrinthitis and vestibular neuritis.

  • Viral infections are the most common cause. Most often cold or flu viruses, but also others, including the varicella zoster virus (that causes shingles), and the mumps, measles and rubella viruses.
  • Bacterial infections, usually middle ear infection (otitis media) or meningitis, that spread to your inner ear. These are more common in children than in adults.
  • Autoimmune conditions affecting your inner ear. This is a less common cause. If you have an autoimmune condition, your immune system mistakenly attacks some of your body's healthy tissues, causing inflammation and damage.
  • Damage to your inner ear, due to an underlying disease, such as meningitis, circulatory problems or Ménière’s disease.

There’s no evidence that other factors, such as stress or allergy can increase your risk of labyrinthitis or vestibular neuritis. Having one of these conditions can make you feel more stressed or anxious though, which can worsen your symptoms.

Symptoms of labyrinthitis and vestibular neuritis

The symptoms of labyrinthitis and vestibular neuritis may come on suddenly. Symptoms of the two conditions can be very similar. You may:

  • have vertigo – this is the feeling that you, or things around you, are spinning even when you're still
  • feel sick or be sick (vomit)
  • feel dizzy and unbalanced

If you have labyrinthitis you may also:

  • have some hearing loss – this ranges from mild loss to losing your hearing altogether
  • have tinnitus (a ringing sound in your ears)

Your eyes may also move around quickly, which you can’t control (called nystagmus), but this isn’t always noticeable unless you’re being examined by a healthcare professional.

Labyrinthitis and vestibular neuritis are often associated with respiratory tract infections, such as colds or flu. So, you may also have symptoms, such as a sore throat, runny nose and raised temperature (fever).

These symptoms aren’t always caused by labyrinthitis or vestibular neuritis – there are a number of other things that can cause them too. If they don’t get better after a few days or your symptoms are particularly severe, make an appointment with your GP.

 Earwax removal

Bupa’s earwax removal service is a safe & effective way to remove earwax. Our Health Advisors are trained and accredited in ear wax removal, using a method called microsuction, which uses a specialist suction device and camera that looks inside your ear. Find out more about our Earwax removal service >

Diagnosis of labyrinthitis and vestibular neuritis

Your GP will usually be able to diagnose labyrinthitis and vestibular neuritis by examining you and asking you about your symptoms. They’ll ask you to describe your symptoms – when you notice them, how long they last and if there’s anything that makes them worse. Your GP may also ask you about other medical problems you’ve had recently, or in the past. Tell your GP about any medicines you’re taking too.

Your GP will look into your ear using a device called an otoscope. This is to check for signs of inflammation and infection in your outer or middle ear which may have spread to your inner ear. Your GP may look at your eyes, sometimes while turning your head to check your reflexes. They may test your balance too, by asking you to walk around. They’ll also test your hearing, often with a tuning fork.

Most of the time, you won’t need any further tests for labyrinthitis and vestibular neuritis. But if your symptoms are particularly severe, or your GP is unsure what’s causing your symptoms, they may refer you to a specialist for further tests. They may carry out further tests to check your hearing and to see how well your vestibular (balance) system is working. They might also suggest an MRI or CT scan to help rule out other causes of your symptoms.

Self-help for labyrinthitis and vestibular neuritis

If you have labyrinthitis or vestibular neuritis, you’ll usually start to feel better after a few days’ rest at home. But it can take several weeks for your symptoms to go completely. There are many things you can do to manage your symptoms while you recover.

At first, when your vertigo and sickness are at their worst, you may want to rest in bed. When you have an attack of vertigo, it may help if you lie still and close your eyes until your symptoms go away. But try to be as active as you can as soon as possible because this will help you to recover more quickly. Keep your fluid levels up by making sure you’re drinking enough water, especially if you’re being sick.

Your symptoms may come and go while you’re recovering. You might find various things make them worse, such as drinking alcohol, feeling tired or having another illness. It’s important that you don’t drive or operate machinery while you have symptoms or are taking medicines for your symptoms. See our FAQ below: Can I drive with labyrinthitis and vestibular neuritis?

If your symptoms get worse while you’re at home or you develop new symptoms, contact your GP.

Treatment of labyrinthitis and vestibular neuritis

Most people with labyrinthitis and vestibular neuritis can be treated at home with the self-help measures above, and if necessary, prescribed medicines to ease their symptoms. Very occasionally, you may need to be admitted to hospital if you’re being sick (vomiting) a lot.

You may also need to be referred to a specialist doctor if you have sudden hearing loss. You may need immediate treatment to stop your hearing loss getting any worse.

Medicines for labyrinthitis and vestibular neuritis

Your doctor can prescribe anti-sickness medicines to help with vertigo, nausea and vomiting. You usually only take these medicines for a short time because otherwise they may slow down your recovery.

Some of these medicines can cause drowsiness, so you shouldn’t drive, cycle or operate machinery while taking them, even if your vertigo seems better. Speak to your doctor about how your medicine may affect you and always read the patient information leaflet that comes with it.

Antibiotics don’t work for vestibular neuritis or labyrinthitis, but if you have an underlying bacterial middle ear infection, they may be prescribed to help with that.

Vestibular rehabilitation therapy

If you’re still feeling dizzy and unsteady after a few weeks, your doctor may suggest you have vestibular rehabilitation therapy. This involves doing a range of specially designed exercises to improve your balance. It may include exercises in which you move your head or eyes, and others to improve your balance while standing or walking.

These exercises teach your brain to use the information from your eyes, joints and muscles. This helps you balance, even though there is confusing information coming from your inner ear. You might also have help from a physiotherapist.

Vestibular rehabilitation therapy can help with your balance and walking, and make everyday activities easier.

Complications of labyrinthitis and vestibular neuritis

Labyrinthitis and vestibular neuritis usually clear up on their own without any complications. Your vertigo should get better within a few days. But some people continue to feel unsteady even after the initial spinning and dizziness have gone away. This can last a long time – weeks or even months. It can make you more likely to fall over.

Sometimes, labyrinthitis can cause permanent hearing loss. It can also cause lasting damage to the balance system in your inner ear. Whether or not this happens may depend on which type of labyrinthitis you have. This is more likely to happen if you have a bad case of bacterial labyrinthitis. You can ask your doctor if you’re likely to have any long-term problems, but this may not be easy to predict.

Frequently asked questions about labyrinthitis and vestibular neuritis

  • Labyrinthitis is a condition that affects your inner ear. It can cause vertigo, dizziness, nausea (feeling sick) and vomiting (being sick). You might also have some hearing loss or tinnitus (a ringing sound in your ears). For more information see ‘What are labyrinthitis and vestibular neuritis?’

  • If you have labyrinthitis or vestibular neuritis, you’ll usually start to feel better after a few days’ rest at home. But it can take several weeks for your symptoms to go completely.

  • You shouldn’t drive if you have symptoms of labyrinthitis or vestibular neuritis, such as dizziness and vertigo. You also shouldn’t operate any machinery. This is for your own safety and the safety of others.

    You should inform the DVLA (Driver and Vehicle Licensing Agency) if you have labyrinthitis, dizziness or vertigo. The DVLA will assess your case and let you know what happens next. This could take up to six weeks. The decision will depend on your individual circumstances. They may contact your doctor, arrange for you to be examined or ask you to have a driving assessment.

    You should also tell your motor insurer about your labyrinthitis or vestibular neuritis.

  • If you feel dizzy, it means you may feel light-headed or unsteady. You can feel dizzy without having vertigo. You should get checked by your GP if you faint or feel dizzy for no obvious reason.

    Vertigo is a more specific feeling that you, or things around you, are spinning even when you’re still.

    Vertigo is caused by problems affecting your inner ear, or the parts of your nervous system that control balance. It can make you feel sick and be sick (vomit). Many people still describe it as feeling dizzy, though.

  • Labyrinthitis and vestibular neuritis aren’t contagious. This means you can’t catch them directly from someone who already has them. But you may catch infections such as a cold or flu from someone else, that can then trigger viral labyrinthitis or vestibular neuritis.

  • Flying with labyrinthitis, vestibular neuritis or any ear infection isn’t ideal. The changes in air pressure, motion changes and changes in lighting can make you feel worse, and it might be better to wait until you feel better. It doesn’t mean you definitely can’t travel, but it’s a good idea to talk to your doctor if you’re planning to fly. Here are some ways to manage discomfort when flying.

    • Take sunglasses to help with visual disturbances.
    • Try to stay awake during the descent – this is when most people are affected by air pressure changes.
    • Manage air pressure changes and help your ears pop by swallowing water, yawning, or sucking a sweet or chewing gum. You can also pinch your nose and blow gently through your nose until your ears pop.
    • Stay well hydrated by making sure you’re drinking enough water, and avoid drinking alcohol.

Did our information help you?

We’d love to hear what you think. Our short survey takes just a few minutes to complete and helps us to keep improving our health information.

About our health information

At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.

Our information has been awarded the PIF TICK for trustworthy health information. It also follows the principles of the The Information Standard.

The Patient Information Forum tick

Learn more about our editorial team and principles >

Related information

    • Labyrinthitis. BMJ Best Practice., last reviewed 30 August 2020
    • Vestibular neuronitis. NICE Clinical Knowledge Summaries., last reviewed November 2017
    • Vestibular neuritis and labyrinthitis. Patient., last edited 2 November 2016
    • Inner ear. Encyclopaedia Britannica., accessed 30 September 2020
    • Introduction to inner ear disorders. MSD Manual., last full review/revision April 2020
    • Saman Y, Bamiou DE, Gleeson M, et al. Interactions between stress and vestibular compensation – a review. Front Neurol 2012; 3:116. doi: 10.3389/fneur.2012.00116
    • Physiotherapy works: vestibular rehabilitation. Chartered Society of Physiotherapy., last reviewed 6 July 2017
    • McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD005397. DOI: 10.1002/14651858.CD005397.pub4
    • Check if a health condition affects your driving., accessed 2 October 2020
    • Medical conditions, disabilities and driving. What happens after you tell DVLA., accessed 2 October 2020
    • Neurology. Oxford handbook of general practice. Oxford Medicine Online., published online June 2020
    • Assessment of dizziness. BMJ Best Practice., last reviewed 2 September 2020
    • Overview of vertigo. BMJ Best Practice., last reviewed 2 September 2020
    • Common cold. Patient., last reviewed 10 November 2016
    • Personal communication. Mr Anil Banerjee, Ear, Nose and Throat Consultant, 21 October 2020
    • Travel and vestibular disorders. Vestibular Disorders Association., accessed 2 October 2020
  • Reviewed by Pippa Coulter, Freelance Health Editor, October 2020
    Expert reviewer Mr Anil Banerjee, Ear, Nose and Throat Consultant
    Next review due October 2023