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How labyrinthitis develops
How labyrinthitis develops
Published: 2013/08/06
Channel: Bupa Health UK
Labyrinthitis, My Experience & Symptoms.
Labyrinthitis, My Experience & Symptoms.
Published: 2015/08/22
Channel: Richard Oldroyd
How to Treat Labyrinthitis Naturally (Vestibular Neuritis)
How to Treat Labyrinthitis Naturally (Vestibular Neuritis)
Published: 2017/07/17
Channel: Natural Cures
Labyrinthitis Symptoms | How to Cure Labyrinthitis Symptoms
Labyrinthitis Symptoms | How to Cure Labyrinthitis Symptoms
Published: 2016/08/11
Channel: Men & Women Health Hub
VRT Vestibular Rehab Exercises for labyrinthitis and Vestibular neuritis
VRT Vestibular Rehab Exercises for labyrinthitis and Vestibular neuritis
Published: 2016/09/15
Channel: Sharon Hen
My Labyrinthitis Story
My Labyrinthitis Story
Published: 2017/11/15
Channel: Mama Does Homeschool
What is LABYRINTHITIS? What does LABYRINTHITIS mean? LABYRINTHITIS meaning, definition & explanation
What is LABYRINTHITIS? What does LABYRINTHITIS mean? LABYRINTHITIS meaning, definition & explanation
Published: 2017/08/04
Channel: The Audiopedia
How labyrinthitis develops
How labyrinthitis develops
Published: 2016/03/31
Channel: Medical Video
What is Vestibular Neuritis & Labyrinthitis?
What is Vestibular Neuritis & Labyrinthitis?
Published: 2017/10/06
Channel: Advanced Motion Rehabilitation, LLC
Labyrinthitis
Labyrinthitis
Published: 2016/07/10
Channel: Health Watch
I HAVE LABYRINTHITIS :(
I HAVE LABYRINTHITIS :(
Published: 2017/05/01
Channel: Jessy Rose
Labyrinthitis, 5 Weeks In
Labyrinthitis, 5 Weeks In
Published: 2007/06/07
Channel: Brad Reynolds
Labyrinthitis
Labyrinthitis
Published: 2016/06/06
Channel: Troy Holloway
Labyrinthitis - 1 year update - 100% better
Labyrinthitis - 1 year update - 100% better
Published: 2017/06/20
Channel: Sharon Hen
Labyrinthitis ¦ Treatment and Symptoms
Labyrinthitis ¦ Treatment and Symptoms
Published: 2013/03/07
Channel: MainMD
Labyrinthitis - Viewer Question - Dr John - 2015
Labyrinthitis - Viewer Question - Dr John - 2015
Published: 2016/02/02
Channel: sixesfullofnines
my story with labyrinthitis
my story with labyrinthitis
Published: 2015/06/23
Channel: Michael Rosenbloom
Vestibular Neuritis / Labyrinthitis 2 Years Later | Dizziness | My Progress & Recovery | Tips
Vestibular Neuritis / Labyrinthitis 2 Years Later | Dizziness | My Progress & Recovery | Tips
Published: 2016/08/26
Channel: Simply Seth
Labyrinthitis
Labyrinthitis
Published: 2014/08/28
Channel: Audiopedia
Best Home Treatment For Labyrinthitis  - How To Treat Vastibular Neuritis
Best Home Treatment For Labyrinthitis - How To Treat Vastibular Neuritis
Published: 2017/07/20
Channel: ultimate home remedies
Viral Labyrinthitis (I
Viral Labyrinthitis (I'm on a Boat!)
Published: 2017/08/01
Channel: Emily is Vlogging
How to Treat Labyrinthitis Naturally Vestibular Neuritis
How to Treat Labyrinthitis Naturally Vestibular Neuritis
Published: 2017/09/25
Channel: Superfoods You Need
Labyrinthitis and Vestibular Neuritis Recovery
Labyrinthitis and Vestibular Neuritis Recovery
Published: 2016/08/31
Channel: Sharon Hen
Labyrinthitis and Vertigo (BPPV): Hazel
Labyrinthitis and Vertigo (BPPV): Hazel's story
Published: 2017/11/06
Channel: NHS Choices
LABRYNTHITIS AGAIN HELP ME
LABRYNTHITIS AGAIN HELP ME
Published: 2015/11/12
Channel: Kat Ward
01 Jacob Kirkegaard - Labyrinthitis [Touch]
01 Jacob Kirkegaard - Labyrinthitis [Touch]
Published: 2013/03/17
Channel: touchmusic33
Vestibular Neuritis Update (6 Months) Labyrinthitis Dizziness
Vestibular Neuritis Update (6 Months) Labyrinthitis Dizziness
Published: 2016/06/13
Channel: Rob Dimension
Ronnie Corbett talks about his battle with Labyrinthitis
Ronnie Corbett talks about his battle with Labyrinthitis
Published: 2014/01/01
Channel: sixesfullofnines
Labyrinthitis (Vertigo) : Causes, Diagnosis, Symptoms, Treatment, Prognosis
Labyrinthitis (Vertigo) : Causes, Diagnosis, Symptoms, Treatment, Prognosis
Published: 2017/07/15
Channel: Dr. Warraich Health Channel
9 month labyrinthitis update
9 month labyrinthitis update
Published: 2016/04/14
Channel: sian dayy
How labyrinthitis develops
How labyrinthitis develops
Published: 2012/12/31
Channel: عالم الكمبيوتر
Labyrinthitis, For Those Without It
Labyrinthitis, For Those Without It
Published: 2008/04/02
Channel: Brad Reynolds
My life with Vestibular Neuritis
My life with Vestibular Neuritis
Published: 2013/07/20
Channel: Vegan Beast From The East
My experience with Labyrinthitis.
My experience with Labyrinthitis.
Published: 2016/10/31
Channel: Alison Hill
labyrinthitis
labyrinthitis
Published: 2015/04/12
Channel: Jeff Walter
How to Treat Labyrinthitis Naturally Vestibular Neuritis
How to Treat Labyrinthitis Naturally Vestibular Neuritis
Published: 2017/09/14
Channel: GREEN LIFE
Labyrinthitis (3+Weeks)
Labyrinthitis (3+Weeks)
Published: 2017/10/03
Channel: Carl Desmond
Labyrinthitis with Subtitles
Labyrinthitis with Subtitles
Published: 2011/09/28
Channel: earsite1
Vestibular Exercises for labyrinthitis/migraine with vertigo
Vestibular Exercises for labyrinthitis/migraine with vertigo
Published: 2016/11/14
Channel: sian dayy
Labyrinthitis: Final Video
Labyrinthitis: Final Video
Published: 2009/01/11
Channel: Brad Reynolds
Labyrinthitis & septoplasty update
Labyrinthitis & septoplasty update
Published: 2017/05/09
Channel: sian dayy
How to treat Labyrinthitis
How to treat Labyrinthitis
Published: 2016/03/09
Channel: Willow
Isochronic Tone - 118HZ - Fibromyalgia, Labyrinthitis, Craniopharyngioma, ++
Isochronic Tone - 118HZ - Fibromyalgia, Labyrinthitis, Craniopharyngioma, ++
Published: 2016/06/14
Channel: Anthony Sommer
labyrinthitis
labyrinthitis
Published: 2008/05/26
Channel: fishhead06
What Is The Difference Between Labyrinthitis And Vestibular Neuritis?
What Is The Difference Between Labyrinthitis And Vestibular Neuritis?
Published: 2017/09/02
Channel: I Question You
labyrinthitis treatment
labyrinthitis treatment
Published: 2012/12/17
Channel: Tri Febriati
How to Treat Labyrinthitis Naturally Vestibular Neuritis
How to Treat Labyrinthitis Naturally Vestibular Neuritis
Published: 2017/07/20
Channel: Mahnoor Tips
Labyrinthitis, Week 7
Labyrinthitis, Week 7
Published: 2007/06/21
Channel: Brad Reynolds
Labyrinthitis
Labyrinthitis
Published: 2009/04/14
Channel: AgoraphobiaProject
Labyrinthitis is actually migraine associated vertigo
Labyrinthitis is actually migraine associated vertigo
Published: 2016/07/30
Channel: sian dayy
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WIKIPEDIA ARTICLE

From Wikipedia, the free encyclopedia
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Labyrinthitis
Synonyms Otitis interna, vestibular neuronitis, vestibular neuritis
Specialty Otorhinolaryngology
Frequency 35 per million per year[1]

Labyrinthitis, also known as vestibular neuritis,[2][3] is the inflammation of the inner ear. It results in vertigo and also possible hearing loss or ringing in the ears. It can occur as a single attack, a series of attacks, or a persistent condition that diminishes over three to six weeks. It may be associated with nausea, vomiting, and eye nystagmus.

The cause is often not clear. It may be due to a virus, but it can also arise from bacterial infection, head injury, extreme stress, an allergy, or as a reaction to medication. 30% of affected people had a common cold prior to developing the disease.[1] Either bacterial or viral labyrinthitis can cause permanent hearing loss in rare cases.[4] This appears to result from an imbalance of neuronal input between the left and right inner ears.[5]

Vestibular neuritis affects approximately 35 per million people per year.[1] It typically occurs in those between 30 and 60 years of age.[1] There is no significant gender difference.[1] It derives its name from the labyrinths that house the vestibular system, which senses changes in head position.

Signs and symptoms[edit]

The main symptom of labyrinthitis is severe vertigo. Rapid and undesired eye motion (nystagmus) often results from the improper indication of rotational motion. Nausea, anxiety, and a general ill feeling are common due to the distorted balance signals that the brain receives from the inner ear.

Causes[edit]

Some people will report having an upper respiratory infection (common cold) or flu prior to the onset of the symptoms of vestibular neuronitis; others will have no viral symptoms prior to the vertigo attack.

Some cases of vestibular neuronitis are thought to be caused by an infection of the vestibular ganglion by the herpes simplex type 1 virus.[5] However, the cause of this condition is not fully understood, and in fact many different viruses may be capable of infecting the vestibular nerve.

Acute localized ischemia of these structures also may be an important cause, especially in children, vestibular neuritis may be preceded by symptoms of a common cold. However, the causative mechanism remains uncertain.[6]

This can also be brought on by pressure changes such as those experienced while flying or scuba diving.[7][8][9]

Mechanism[edit]

The vestibular system is a set of sensory inputs consisting of three semicircular canals, sensing changes in rotational motion, and the otoliths, sensing changes in linear motion. The brain combines visual cues with sensory input from the vestibular system to determine adjustments required to retain balance. The vestibular system also relays information on head movement to the eye muscle, forming the vestibulo–ocular reflex to retain continuous visual focus during motion.

Diagnosis[edit]

Treatment[edit]

The treatment for vestibular neuronitis depends on the cause. However, symptoms of vertigo can be treated in the same way as other vestibular dysfunctions with vestibular rehabilitation.[10]

Physical therapy[edit]

Typical treatments include combinations of head and eye movements, postural changes, and walking exercises. Specifically, exercises that may be prescribed include keeping eyes fixated on a specific target while moving the head, moving the head right to left at two targets at a significant distance apart, walking while keeping eyes fixated on a specific target, and walking while keeping eyes fixated on a specific target while also turning the head in different directions.[11] The main function behind repeating a combination of head and eye movements, postural changes and walking is that through this repetition, compensatory changes for the dysfunctions arising from peripheral vestibular structures may be promoted in the central vestibular system (brainstem and cerebellum).[11]

Vestibular rehabilitation therapy is a highly effective way to substantially reduce or eliminate residual dizziness from labyrinthitis. VRT works by causing the brain to use already existing neural mechanisms for adaptation, neuroplasticity, and compensation.[10]

Rehabilitation strategies most commonly used are:[10]

  • Gaze stability exercises – moving the head from side to side while fixated on a stationary object (aimed at assisting the eye to fixate during head rotation without the input from the lost canal vestibulo–ocular reflex) An advanced progression of this exercise would be walking in a straight line while looking side to side by turning the head.
  • Habituation exercises – movements designed to provoke symptoms and subsequently reduce the negative vestibular response upon repetition. Examples of these include Brandt–Daroff exercises.
  • Functional retraining – including postural control, relaxation, and balance training.

These exercises function by challenging the vestibular system. Progression occurs by increasing the amplitude of the head or focal point movements, increasing the speed of movement, and combining movements such as walking and head turning.

One study found that patients who believed their illness was out of their control showed the slowest progression to full recovery, long after the initial vestibular injury had healed.[12] The study revealed that the patient who compensated well was one who, at the psychological level, was not afraid of the symptoms and had some positive control over them. Notably, a reduction in negative beliefs over time was greater in those patients treated with rehabilitation than in those untreated. "Of utmost importance, baseline beliefs were the only significant predictor of change in handicap at 6 months followup."

Medication[edit]

Vestibular neuronitis is generally a self-limiting disease. Treatment with drugs is neither necessary nor possible. The effect of glucocorticoids has been studied, but they have not been found to significantly affect long-term outcome.[13]

Symptomatic treatment with antihistaminics such as cinnarizine, however, can be used to suppress the symptoms of vestibular neuronitis while it spontaneously regresses.[14] Prochlorperazine is another commonly prescribed medication to help alleviate the symptoms of vertigo and nausea.

Studies have shown that older adults with dementia who take antipsychotics (medications for mental illness) such as prochlorperazine have an increased chance of death during treatment.[15]

Other[edit]

Because mood disorders can interfere with the vestibular compensation and adaptive plasticity, it suggested to address any co-occurring anxiety disorder and/or depression. Severe anxiety episodes are usually addressed by short-term benzodiazapine therapy. Long-term use of benzodiazapines such as diazepam, however, is not recommended due to the tolerance issues.[16] SSRIs and SSNRIs are among a number of first line treatments for anxiety or depression. [17]

Prognosis[edit]

In most cases, the condition tends to be self-limiting. In 95% or greater, vestibular neuritis is a one-time experience with most people fully recovering.[18]

Recovery from acute labyrinthine inflammation generally takes from one to six weeks, but it is not uncommon for residual symptoms (dysequilibrium and/or dizziness) to last for a couple of months.[12]

Recovery from a temporary damaged inner ear typically follows two phases:

  1. An acute period, which may include severe vertigo and vomiting
  2. approximately two weeks of sub-acute symptoms and rapid recovery

References[edit]

  1. ^ a b c d e Greco, A; Macri, GF; Gallo, A; Fusconi, M; De Virgilio, A; Pagliuca, G; Marinelli, C; de Vincentiis, M (2014). "Is vestibular neuritis an immune related vestibular neuropathy inducing vertigo?". Journal of Immunology Research. 2014: 459048. doi:10.1155/2014/459048. PMC 3987789Freely accessible. PMID 24741601. 
  2. ^ Ferri's Clinical Advisor 2016: 5 Books in 1. Elsevier Health Sciences. 2015. p. 735. ISBN 9780323378222. 
  3. ^ Hogue, JD (June 2015). "Office Evaluation of Dizziness". Primary care. 42 (2): 249–258. doi:10.1016/j.pop.2015.01.004. PMID 25979586. 
  4. ^ "NLM". 
  5. ^ a b Marill, Keith (2011-01-13). "Vestibular Neuronitis: Pathology". eMedicine, Medscape Reference. Retrieved 2011-08-07. 
  6. ^ Keith A Marill. "Vestibular Neuronitis". Retrieved 2008-06-28. 
  7. ^ Martin-Saint-Laurent A, Lavernhe J, Casano G, Simkoff A (March 1990). "Clinical aspects of inflight incapacitations in commercial aviation". Aviation, Space, and Environmental Medicine. 61 (3): 256–60. PMID 2317181. 
  8. ^ Farmer, Jr JC, ed. (1973). Labyrinthine Dysfunction During Diving. 1st Undersea and Hyperbaric Medical Society Workshop. UHMS Publication Number WS6-15-74. Undersea and Hyperbaric Medical Society. p. 11. Retrieved 2009-03-11. 
  9. ^ Kennedy RS (March 1974). "General history of vestibular disorders in diving". Undersea Biomedical Research. 1 (1): 73–81. PMID 4619861. Retrieved 2009-03-11. 
  10. ^ a b c Burton M. J.; Monsell E. M.; Rosenfeld R. M. (2008). "Extracts from the cochrane library: Vestibular rehabilitation for unilateral peripheral vestibular dysfunction (review)". Otolaryngology – Head and Neck Surgery. 138 (4): 415–417. doi:10.1016/j.otohns.2008.02.004. 
  11. ^ a b Walker, MF (January 2009). "Treatment of vestibular neuritis". Current Treatment Options in Neurology. 11 (1): 41–5. doi:10.1007/s11940-009-0006-8. PMID 19094835. 
  12. ^ a b Bronstein, Adolfo (February 2002). "Visual and psychological aspects of vestibular disease". Current Opinion in Neurology. 15 (1): 1–3. doi:10.1097/00019052-200202000-00001. PMID 11796943. 
  13. ^ Fishman, JM; Burgess C; Waddell A (May 2011). "Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis)". Cochrane Database Syst Rev (5): CD008607. doi:10.1002/14651858.CD008607.pub2. PMID 21563170. 
  14. ^ Scholtz, AW; Steindl R; Burchardi N; Bognar-Steinberg I; Baumann W (June 2012). "Comparison of the therapeutic efficacy of a fixed low-dose combination of cinnarizine and dimenhydrinate with betahistine in vestibular neuritis: a randomized, double-blind, non-inferiority study". Clin Drug Investig. 32 (6): 387–399. doi:10.2165/11632410-000000000-00000. PMID 22506537. 
  15. ^ "Prochlorperazine". 
  16. ^ Solomon, D; Shepard, NT (July 2002). "Chronic Dizziness". Current Treatment Options in Neurology. 4 (4): 281–288. doi:10.1007/s11940-002-0028-y. PMID 12036501. 
  17. ^ Vries, Ya (March 2016). "Influence of baseline severity on antidepressant efficacy for anxiety disorders: meta-analysis and meta-regression". British Journal of Psychiatry. 208: 515–21. doi:10.1192/bjp.bp.115.173450. PMID 26989093. 
  18. ^ "Vestibular Neuritis". Cleveland Clinic. Retrieved 2014-12-18. 

External links[edit]

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