Labyrinthitis and vestibular neuritis
Your health expert: Mr Jonathan Hughes, Ear, Nose and Throat Consultant
Content editor review by: Sheila Pinion, October 2023
Next review due October 2026
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.
How labyrinthitis develops
Labyrinthitis | Watch in 1:36 minutes
Labyrinthitis is when your inner ear becomes inflamed. This can affect the hearing and balance systems in your inner ear.
Labyrinthitis is when your inner ear, called the labyrinth, becomes inflamed, usually because of an infection.
It can affect your balance, make you feel dizzy and sick, and cause hearing loss.
Your ear is made up of three parts: your outer ear, your middle ear and your inner ear.
Your inner ear is also known as the labyrinth.
This is made up of your cochlea, which helps you to hear, and a system of tubes that help you to balance.
These tubes are filled with fluid and lined with tiny hairs.
When you move your head, the fluid within these tubes moves these tiny hairs which then triggers a signal to be sent your brain.
Your brain uses these signals from your inner ear, along with other signals from your eyes, muscles and joints to control movement and balance.
But if you have labyrinthitis, the signals from your inner ear to your brain get mixed up, and the messages between your ears, eyes, muscles and joints are no longer in sync.
You may feel as though you're moving, even when you're still, which can make you feel very dizzy.
If you have labyrinthitis, your symptoms may be very severe at first.
Sometimes, symptoms may last for several months, but usually, they get better within a few weeks.
About 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. They normally affect one ear, but can affect both
Causes of labyrinthitis and vestibular neuritis
Various things can cause labyrinthitis or vestibular neuritis.
- Viral infections are thought to be the most common cause – especially upper respiratory tract infections, such as colds or flu. Other viruses, including the varicella zoster virus (which causes shingles), and mumps and rubella viruses, have also been linked to labyrinthitis.
- Bacterial infections, usually middle ear infection (otitis media) or meningitis, that spread to your inner ear.
- Autoimmune conditions affecting your inner ear. 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, allergy, or certain foods can increase your risk of labyrinthitis or vestibular neuritis.
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, even when you’re resting
If you have labyrinthitis you may also:
- have some hearing loss – this can range from mild hearing loss to losing your hearing altogether. It can affect one or both ears
- 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.
Diagnosis of labyrinthitis and vestibular neuritis
Your GP will usually be able to diagnose labyrinthitis and vestibular neuritis by examining you and asking 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. You should tell your GP about any medicines you’re taking, as some can cause vertigo.
Your GP will look into your ear using a device called an otoscope, to check for signs of inflammation or infection. Your GP may look at your eyes, sometimes while turning your head to check your reflexes. They may test your balance by asking you to walk around, and test your hearing 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 severe, or your GP is unsure what’s causing them, they may refer you to an ear, nose and throat (ENT) specialist for further tests. They may carry out further tests to check your hearing and to see how well your balance (vestibular) system is working. They might also suggest an MRI or CT scan to help rule out other causes of your symptoms.
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Self-help for labyrinthitis and vestibular neuritis
If you have labyrinthitis or vestibular neuritis, symptoms of vertigo and sickness will usually ease after a few weeks, even if you don’t receive treatment. There are several 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.
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 an ear, nose and throat (ENT) specialist 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 exercises to improve your balance and reduce dizziness. You may do exercises in which you move your head or eyes, and others to improve your balance while standing or walking. You might also have help from a physiotherapist.
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. This is because your nervous system has to adapt to the changes in your ear to get rid of the feeling of vertigo. Vestibular rehabilitation can help with this.
If labyrinthitis is caused by bacteria (also known as suppurative labyrinthitis), it can cause permanent hearing loss. It can also cause lasting damage to the balance system in your inner ear. You can ask your doctor if you’re likely to have any long-term problems, but this may not be easy to predict.
Labyrinthitis is a condition that affects your inner ear. It can cause vertigo and dizziness. It may also make you feel sick (nausea) and be sick (vomit). You might also have some hearing loss or a ringing sound in your ears (tinnitus). For more information see the section on ‘what is labyrinthitis and vestibular neuritis?’
If you have labyrinthitis or vestibular neuritis, you’ll usually start to feel better after a few days of rest. 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.
You should inform the DVLA (Driver and Vehicle Licensing Agency) if you have labyrinthitis, dizziness or vertigo.
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.
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.
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.
Acute middle ear infection in children
If you’re a parent you’ll probably know that middle ear infections are common in children, and unfortunately they’re often painful.
Tinnitus
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