Labyrinthitis, sensorineural hearing loss accompanied by vertigo\/imbalance, and vestibular neuritis, vertigo\/imbalance without hearing loss, are similar but distinct entities. In both diseases, the patient experiences sudden vertigo for several days followed by chronic imbalance that can last for weeks to months. During the acute phase, patients are nauseated, vomit, and may suffer serious falls. They are often seriously debilitated and cannot drive or work. A mild to moderate headache is typically present for days. For patients with labyrinthitis, patients suffer a sensorineural hearing loss of acute onset that may be mild, moderate, severe, or even profound.<\/p>\n\n\n\n
Vestibular neuritis is thought to be due to inflammation of the vestibular ganglion (where nerve cell bodies of the vestibular nerve reside) while labyrinthitis affects the entire inner ear. A recent history of upper respiratory infection is common. Both diseases are diagnoses of exclusion in that more sinister causes of such symptoms like strokes or brain tumors must be ruled out. Most patients initially present to the Emergency Department where a head CT scan, laboratory profile, and EKG are performed, which are negative. They are discharged from the ER with vestibular suppressants such as Valium and anti-nausea medications such as Phenergan and asked to make an appointment for ENT follow up.<\/p>\n\n\n\n