Labyrinthitis Flashcards
1
Q
Labyrinthitis vs Vestibular Neuritis
A
- Sometimes used interchangeably
- Labyrinthitis for when vestibular nerve and labyrinth affected, hearing loss, dizziness
- Vestibular neuritis when vestibular nerve only is affected, therefore dizziness without hearing loss
2
Q
Vestibular Neuritis Aetiology
A
- Reactivation of HSV1
- Prior URTI
3
Q
Labyrinthitis Aetiology
A
- Viral
- Bacterial can occur
4
Q
Vestibular Neuritis and Labyrinthitis Epidemiology
A
- More common in adults
- Bacterial cause rare
5
Q
Vestibular Neuritis and Labyrinthitis Presentation
A
- Sudden, spontaneous, severe and incapacitating vertigo
- Not triggered by movement but exacerbated by movement
- Nausea and vomiting frequent
- Tinnitus and hearing loss in labyrinthitis
- Previous URTI
6
Q
Vestibular Neuritis and Labyrinthitis Symptoms That Suggest Alternative Diagnosis
A
- Otorrhoea
- Otalgia
- Neck pain/stiffness
- Facial weakness
- CV RFs
- Medications
- FHx of migraine or Ménière’s
7
Q
Vestibular Neuritis and Labyrinthitis Examination
A
- Ear
- Cranial nerves
- Gait
- HINTS for ruling out stroke
- An abnormal head impulse test, unidirectional nystagmus and no vertical skew are sensitive markers of vestibular neuritis and of labyrinthitis
8
Q
Vestibular Neuritis and Labyrinthitis Investigations
A
- Bloods not helpful
- C+S if effusion
- Most do not require imaging unless alternative pathology suspected
- Audiometry if indicated
9
Q
Vestibular Neuritis and Labyrinthitis Differentials
A
- Serous labyrinthitis (inflammation in absence of direct bacterial contamination, toxins and cytokines leak through from acute/chronic OM)
- BPPV
- Vestibular migraine
- Ramsay-Hunt
10
Q
Vestibular Neuritis and Labyrinthitis Management
A
- Admission if sudden-onset unilateral hearing loss
- Otherwise reassurance
- Symptomatic treatment with prochlorperazine or antiemetics
- Self limiting condition, usually resolves within a few weeks
- Physiotherapy if treatment does not work
- Surgical management if indicated
