Manchester Physio

» What we treat » Vestibular physiotherapy » Labyrinthitis

Labyrinthitis is a vestibular condition affecting the inner ear which causes vertigo symptoms. It is very effectively treated with a vestibular physiotherapy program but can be quite disabling in the early stages.

Above: Vestibular physiotherapy - passive resetting exercises

What is Labyrinthitis

Labyrinthitis is a condition that is caused by a viral infection which affects the inner ear. The labyrinth is the term used to describe the area of the inner ear that control balance and smooth vision. The infection attacks this area and causes inflammation or damage to the structures which tell the brain which way the head is moving. This then results in incorrect messages being sent to the brain causing inappropriate reactions which result in dizziness.

Normally once the infection has gone the body compensates for the damage to the labyrinth and symptoms settle but in a significant number of individuals this compensation does not happen. This is when extra vestibular input is required.

What are the symptoms of Labyrinthitis

The symptoms of Labyrinthitis tend to be quite severe in the first few days and then can last anything from a few weeks to months. The symptoms commonly reported with Labyrinthitis are:

Vertigo
Nausea or Vomiting
Visual disturbance
Fuzzing feeling in the head
Oversensitivity to busy situations
Fatigue

Memory Trouble
Oversensitivity to sound
Tinnitus
Reduced confidence
Panic attacks
Imbalance

Above: Vestibular physiotherapy - passive resetting exercises

The situations which can make the symptoms worse include:

Supermarkets/shops
Darkness
Tiredness
Head Movements
Groups of people when you need to listen and concentrate
Feel under the weather

There tends to be fluctuations in the symptoms from day to day and even times of the day. It can be frustration to think you have improved only to feel worse again later but this is the trend you tend to see with Labyrinthitis.

How is Labyrinthitis diagnosed

Labyrinthitis is diagnosed by taking a history of the onset of the symptoms and combining this with a vestibular assessment. The vestibular assessment would involve:

Eye Tests
Balance Tests
Positional Tests
Gait Analysis

From this a diagnosis can be made but sometimes additional medical test would be completed, these may include:

MRI Scan
Hearing Test
Caloric Test
Vestibular function tests-including rotating chair test and videonystagmography

What treatment can Manchester Physio offer for Labyrinthitis

The treatment that Manchester Physio can offer for Labyrinthitis is comprehensive and addresses all of the problems associated with Labyrinthitis. From the vestibular assessment a treatment plan will be made based on the objective findings.

Treatment will consist mainly of a home exercises program and advice, it includes:

Gaze stability training- this involves exercises to train the eyes to work harder when the head is moving in order to maintain clear visual focus.
Balance retraining- this strengthens the input from the balance sensors to feed correct information into the vestibular system to override incorrect messages from labyrinth.
Functional task practice- practicing task desensitises the vestibular system meaning you can do activities without getting symptoms.
Symptom management strategies- having the mechanisms to cope with symptoms means the condition can be kept under control.
Relaxation advice- having the ability to relax fully helps the body to recover from vestibular symptoms. This may involve relaxation scripts or just general advice on sleep.
Pacing of activity- fatigue plays a big part in Labyrinthitis therefore leaning to pace activities is vital to control symptoms and make a stage recovery. Doing too much too soon overloads the vestibular system.
Graded exposure program to difficult situations- hiding away might seem like a good idea as you do not become dizzy but you need to gradually expose the body to situations which are more challenging. You will be given set tasks to do each day to achieve this.

Treatment for uncompensated vestibular problems like Labyrinthitis is life changing. Initially you will have a greater understanding of the condition and the ability to cope with the symptoms but it can take a number of months to see real changes in your day to day symptoms. While your rehabilitation can take months you do not have to attend the clinic regularly during this time as you will be giving plenty to work on at home before progressions are needed.