Viral Labyrinthitis

Question 1

What is viral labyrinthitis?

Answer 1

It is defined as a condition in which there is inflammation of the membranous labyrinth, affecting both the vestibular and cochlear end organs

Question 2

What are the five risk factors associated with viral labyrinthitis?

Answer 2

Middle Aged, 40 – 70 Years Old

Viral Respiratory Tract Infection

Alcoholism

Smoking

Stress

Question 3

What are the seven clinical features of viral labyrinthitis?

Answer 3

Prodromal Coryzal Features

Nausea & Vomiting

Vertigo

Horizontal Nystagmus

Sensorineural Hearing Loss

Tinnitus

Gait Disturbance

Question 4

What is vertigo?

Answer 4

It is defined as the sensation in which the individual, or their environment, is moving or spinning

Question 5

Describe the vertigo associated with viral labyrinthitis

Answer 5

It tends to be constant, which is exacerbated by movement

However it is important to note that it is not triggered by movement

Question 6

Describe the nystagmus associated with viral labyrinthitis

Answer 6

It is sudden unidirectional and horizontal towards the unaffected side

Question 7

Describe the gait disturbance associated with viral labyrinthitis

Answer 7

It may result in the individual falling towards the affected side

Question 8

What are the two investigations used to diagnose viral labyrinthitis?

Answer 8

Hearing Tests

Head Impulse Test

Question 9

What are the two hearing test results indicative of viral labyrinthitis?

Answer 9

Positive Rinne’s Test, AC > BC

Weber’s Test Lateralises To Unaffected Ear

Question 10

How is the head impulse test conducted?

Answer 10

It test involves asking individuals to keep their eyes fixed on a target, and the examiner moving the patient’s head quickly and unpredictably to 10 – 15 degrees of neck rotation

Question 11

What is normal head impulse test result?

Answer 11

The head movement should stimulate the vestibulo ocular reflex, in which the patient’s eye remain on the target following movement

Question 12

What is a positive head impulse test result?

Answer 12

The head movement results in the patient’s eyes moving off the target, followed by a corrective saccade back to the target

Question 13

What is the first line management option of viral labyrinthitis?

Answer 13

Conservative Management

Question 14

What is the conservative management option of viral labyrinthitis?

Answer 14

It involves education and reassurance, due to the self-limiting nature of episodes

Question 15

What are the two pharmacological management options of viral labyrinthitis?

Answer 15

Anti-Emetics

Antihistamines

Question 16

When are anti-emetics used to manage viral labyrinthitis?

Answer 16

They can be administered to reduce the sensation of dizziness

Question 17

Name an anti-emetic used to manage viral labyrinthitis

Answer 17

Prochlorperazine

Question 18

When are antihistamines used to manage viral labyrinthitis?

Answer 18

They can be administered used to reduce the sensation of dizziness

Question 19

Name an antihistamine used to manage viral labyrinthitis

Answer 19

Cetirizine

Question 20

What condition does viral labyrinthitis present similarly to?

Answer 20

Viral Neuronitis

Question 21

How do we differentiate between viral labyrinthitis and vestibular neuronitis?

Answer 21

Labyrinthitis involves both the vestibular nerve and labyrinth, resulting in vertigo and hearing impairment

Vestibular neuronitis only involves the vestibular nerve and therefore there is vertigo but no hearing impairment