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Labyrinthitis/VestibularNeuritis By:NancyAstrup,PT VestibularSpecialist nd Labyrinthitis/VestibularNeuritisisthe2 mostcommoncauseofvertigo(BenignParoxysmal PositionalVertigo(BPPV)beingthemostcommon).Viralinfectionsarethemostcommonformof labyrinthitis.Infectionsinflametheinnerearorthenervesconnectingthebraintotheinnerear.Normal sensoryinformationisthendisruptedwhichmaycausesymptomssuchasvertigo,dizziness,imbalance, andproblemswithvisionorhearing.Symptomsaremostoftenprecededbyaviralinfectionofthe respiratoryorgastrointestinaltracts. DEFINITIONS: Labyrinthitisoccurswhenbothbranchesofthevestibulocochlearnearareinvolvedresultingin hearingchangesandvertigoordizziness. VestibularNeuritisaffectsonebranchofthevestibulocochlearnervethatinvolvesbalance,but usuallynothearing. SYMPTOMSANDONSET Theprimarysymptomisusuallyasuddenonsetofrotationalvertigo(whichmaybemildto severe)thatismadeworsewithmovementofthehead,andisoftenassociatedwithnystagmus(jerking oftheeyes).Othersymptomsmayincludenausea,vomiting,imbalance,tinnitus(ringingintheear), problemswithvisionandconcentration.Symptomsoftenreduceovera48-72hourperiodandbalance mayreturntonormalin6weeks.Mostoftenaffectedarethosebetween30and60yearsold. TREATMENT Shouldyouexperienceanyoftheabovesymptoms,yourrecoverywillbeacceleratedifyousee avestibularphysicaltherapistorEar,Nose,andThroatdoctorimmediately.Youmaybeprescribedan anti-inflammatorymedicationtoreducetheinflammationonthenervefromyourdoctor.Youwillalso needtobeginvestibularrehabilitationtherapy(VRT),aformofphysicaltherapythatisproventobe beneficialinretrainingthebrain’sabilitytoadapttothealteredsignalsbeingsentfromtheinnerear. Thebrainwilladaptovertimebyaprocesscalledcompensation,whichisfacilitatedbyVRT.Exercises mayprovideimmediatereliefformaytakeseveralweeks.Somepeoplehavetocontinueexercisesona regularbasiswhileothersfunctionwellwithoutcontinuousexercise.Akeycomponenttosuccessisfor thepatienttokeepmoving! Ifsymptomspersist,othertestsmaybeorderedtofurtherdeterminetheextentoftheproblem andlocatetheinvolvedareaintheinnerear.Thesetestsmayincludeanaudiogram(hearingtest)and videonystagmography(VNG)whichmayalsoincludeacalorictestthatmeasuresthedifferencebetween thefunctionsoftheinnerearcomparingthetwosides. Formoreinformation,contactthevestibularphysicaltherapistsattheAPRSDizzinessandBalance Centerat406.587.4501
