Labyrinthitis: Difference between revisions
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*Suppurative form requires antibiotics | *Suppurative form requires antibiotics | ||
*Prochlorperazine 10mg PO q6 prn for nausea/vomiting | *Prochlorperazine 10mg PO q6 prn for nausea/vomiting | ||
*Lorazepam OR diazepam as vestibular depressant | *Lorazepam '''OR''' diazepam as vestibular depressant | ||
*Bed rest and hydration | *Bed rest and hydration | ||
*Corticosteroids controversial especially in concomitant suppurative form | *Corticosteroids controversial especially in concomitant suppurative form | ||
Revision as of 02:05, 31 May 2017
Some sources consider vestibular neuritis and labyrinthitis to be the same thing (some differentiate based on auditory symptoms)
Background
- Infection of cochlear and vestibular apparatus (from middle ear via round/oval windows)
- Acute suppurative labyrinthitis is only cause of peripheral vertigo requiring urgent treatment
- Some sources consider Vestibular Neuritis and Labyrinthitis to be the same thing
- Some differentiate based on auditory symptoms
Clinical Features
- Peripheral vertigo + hearing loss + middle ear findings
- Severity depends on type of labyrinthitis:
- Acute suppurative labyrinthitis
- Caused by extension of infection from otitis media, meningitis, mastoiditis
- Signs of toxicity
- Serous labyrinthitis
- Caused by inflammatory respones to nearby infections (including viral)
- Clinical course similar to Vestibular Neuritis (Neuronitis)
- Acute suppurative labyrinthitis
- Severity depends on type of labyrinthitis:
Differential Diagnosis
Vertigo
- Vestibular/otologic
- Benign paroxysmal positional vertigo (BPPV)
- Traumatic (following head injury)
- Infection
- Ménière's disease
- Ear foreign body
- Otic barotrauma
- Otosclerosis
- Neurologic
- Cerebellar stroke
- Vertebrobasilar insufficiency
- Lateral Wallenberg syndrome
- Anterior inferior cerebellar artery syndrome
- Neoplastic: cerebellopontine angle tumors
- Basal ganglion diseases
- Vertebral Artery Dissection
- Multiple sclerosis
- Infections: neurosyphilis, tuberculosis
- Epilepsy
- Migraine (basilar)
- Other
- Hematologic: anemia, polycythemia, hyperviscosity syndrome
- Toxic
- Chronic renal failure
- Metabolic
Evaluation
See Vertigo
Management
- Suppurative form requires antibiotics
- Prochlorperazine 10mg PO q6 prn for nausea/vomiting
- Lorazepam OR diazepam as vestibular depressant
- Bed rest and hydration
- Corticosteroids controversial especially in concomitant suppurative form
Disposition
- Suppurative form require admission for definitive ENT treatment