Reprinted with permission from http://thedailyscan.providencehealthcare.org/2019/09/inner-ear-problem/
When Andrew Weaver recently tweeted out about an illness that temporarily sidelined him and sent him to hospital, it may have sent many of his followers scurrying for a dictionary.
The British Columbia Green Party leader was recently hospitalized for a condition called labyrinthitis and called its symptoms “debilitating.”
To find out more about this condition, we turned to two of our vestibular audiologists at St. Paul’s Hospital, Yvette Reid and Myron Huen.
Q: What is labyrinthitis?
A: It is an inner-ear inflammation caused by a virus that causes damage to the hair (nerve) cells. It affects the function of both the cochlea (the hearing organ) and the vestibular organ (the balancing mechanism).
Q: How does a person contract this?
A: It is an infection that’s usually viral but in rare cases, bacterial. It can be part of a more systemic virus but the virus may also be restricted to the labyrinth in the inner ear.
Yvette Reid, St. Paul’s audiologist.
Q: What are the symptoms? Andrew Weaver referred to his as “debilitating.”
A: It is certainly unpleasant. Patients experience dizziness, hearing loss and tinnitus, or a ringing/buzzing in the inner-ear. They often feel very sick, and it certainly can be debilitating, particularly the dizziness. Typically, people experience a strong spinning sensation and nausea/vomiting. The dizziness is constant in the acute phase and gets worse if you move about. Most patients end up in the Emergency Department.
Myron Huen, St. Paul’s Hospital audiologist.
Q: How long can labyrinthitis last?
A: The dizziness gradually resolves but that can take weeks or months and in some cases symptoms are ongoing. The hearing loss can be permanent.
Q: How common is it?
A: There’s not a lot of data on prevalence but about five per cent of cases of dizziness are caused by labyrinthitis or a related inner-ear condition, vestibular neuritis.
Q: Who is most at risk of developing this?
A: It most commonly affects people between 30 to 50 years old; some sources note that it’s common for those up to age 60 (Andrew Weaver is 58). Women are about 1.5 times more susceptible than men.
Q: How serious can it be?
A: The condition itself is not life-threatening but it can certainly affect a person’s ability to work and perform other daily activities. Since it’s wise to rule out other causes of the vertigo and hearing loss, a trip to the ED is appropriate. Patients may have a scan to rule out a stroke, or tumour on the auditory nerve. If it is labyrinthitis or neuritis (which causes the dizziness symptoms but doesn’t usually cause hearing loss), then the patient usually receives an injection of Gravol and is sent home to recover.
Occasionally people are still absent from work over a year after onset, though many patients make a full recovery much more quickly.
Q: How is it treated over the longer term?
A: Treatment can depend on the recovery. For some, there may be full recovery of both the hearing and balance function while others are left with deficiencies with one or both functions. When there is permanent inner-ear damage even after the infection has resolved, the brain could interpret the presence of motion even when the person is still. This makes the person feel dizzy.
Many learn to compensate for their balance loss through their regular daily physical activities. If not, rehabilitation by a vestibular therapist (typically a physiotherapist) is recommended to help retrain the brain to accurately interpret vestibular input. Vestibular rehabilitation includes performing different targeted and repetitive exercises, especially those relating to head movement, as well as those that strengthen the other systems that help us balance. If the person suffers permanent hearing loss, a hearing aid would help amplify sounds as well as prevent auditory deprivation to the affected ear.