Labyrinthitis
Basics
Description
- The sudden onset of vertigo, accompanied by sensorineural hearing loss and tinnitus, lasting hours to days, and caused by acute inflammation or infection of the labyrinth of the inner ear
- Can be categorized as suppurative or serous/toxic labyrinthitis (1)
- Labyrinthitis is a clinical diagnosis in absence of neurologic deficits.
- Typically presents with a subjective sense of motion or room-spinning vertigo lasting for hours or days and often sudden unilateral sensorineural hearing loss
- Often associated with vestibular hypofunction of the involved ear; peripheral vertigo improves over time with central compensation. Hearing loss generally improves in the case of serous labyrinthitis but is permanent in the case of suppurative labyrinthitis.
- System(s) affected: nervous, special sensory (auditory and vestibular)
ALERT
- “Vertigo” and “dizziness” are commonly used terms. Clarify the symptoms by giving options of alternative descriptions such as light-headedness, disequilibrium, room-spinning vertigo, or imbalance.
- Hearing loss and duration of symptoms can help narrow the differential diagnosis in patients with vertigo.
- Vestibular neuritis/neuronitis occurs due to inflammation of the vestibular nerve causing vertigo lasting from hours to days without the auditory symptoms of labyrinthitis (2).
Epidemiology
- Most common in 30 to 50 years of age (3)
- 10% of all patients seen for dizziness, if vestibular neuritis is included (4)
Incidence
Estimated incidence of 3.5 per 100,000 if including vestibular neuritis (3)
Etiology and Pathophysiology
- Viral labyrinthitis is the most common etiology with acute inflammation and damage to the labyrinth, involving both the vestibular apparatus and cochlea.
- Common viral: cytomegalovirus, mumps, varicella zoster, rubeola, influenza, parainfluenza, herpes simplex, adenovirus, coxsackievirus, respiratory syncytial virus, HIV
- Bacterial invasion of the inner ear, either from a middle ear infection or meningitis, occurs in suppurative labyrinthitis (1).
- Common bacterial: Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Neisseria meningitidis, Streptococcus spp., Staphylococcus spp., Borrelia burgdorferi
Risk Factors
- Viral upper respiratory infection
- Otitis media
- Cholesteatoma
- Head trauma
- Meningitis
General Prevention
- Early treatment of acute otitis media to prevent complications
- Scheduled immunizations (to prevent common viral pathogens)
- Prevent maternal transmission of pathogens, including syphilis and HIV.
Commonly Associated Conditions
- Viral upper respiratory infection
- Otitis media, cholesteatoma
- Head injury
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Labyrinthitis." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116335/4.0/Labyrinthitis.
Labyrinthitis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116335/4.0/Labyrinthitis. Accessed December 3, 2024.
Labyrinthitis. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116335/4.0/Labyrinthitis
Labyrinthitis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 03]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116335/4.0/Labyrinthitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Labyrinthitis
ID - 116335
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116335/4.0/Labyrinthitis
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -