Labyrinthitis - Treatment 

Treating labyrinthitis 

Labyrinthitis is usually treated using a combination of self-help techniques and medication. Chronic labyrinthitis may be treated with vestibular rehabilitation therapy (VRT).

Self-help

Drink plenty of liquid, particularly water, to avoid becoming dehydrated. You should drink little and often.

In its early stages, labyrinthitis can make you feel constantly dizzy and it can give you severe vertigo. You should rest in bed to avoid falling and injuring yourself. After a few days, the worst of these symptoms should have passed and you should no longer feel dizzy all the time.

You can do several things to minimise any remaining feelings of dizziness and vertigo. For example:

  • during an attack, lie still in a comfortable position (on your side is often best)
  • avoid chocolate, coffee and alcohol
  • stop smoking
  • avoid bright lights
  • try to cut out noise and anything that causes stress from your surroundings

Medication

If your symptoms of dizziness, vertigo and loss of balance are particularly severe, your GP may prescribe a short course of medication such as benzodiazepine or antiemetics (vestibular sedatives).

Benzodiazepine

Benzodiazepines reduce activity inside your central nervous system. This means your brain is less likely to be affected by the abnormal signals coming from your vestibular system.

However, long-term use of benzodiazepines is not recommended because they can be highly addictive if used for long periods.

Antiemetics

A prescription medication known as an antiemetic may be prescribed if you are experiencing nausea and vomiting.

Prochlorperazine 5mg tablets are an antiemetic used to treat the symptoms of vertigo and dizziness. It may be considered as an alternative treatment to benzodiazepines.

Most people are able to tolerate prochlorperazine and side effects are uncommon, but can include tremors (shaking), abnormal or involuntary body and facial movements, and sleepiness.

Check the patient information leaflet that comes with your medicine for a full list of possible side effects.

If you are vomiting, there is a prochlorperazine 3mg tablet available which you place inside your mouth between your gums and cheek.

Corticosteroids

Corticosteroids such as prednisolone may be recommended if your symptoms are particularly severe. They are often effective at reducing inflammation.

Side effects of prednisolone include:

  • an increase in appetite
  • weight gain
  • insomnia
  • fluid retention
  • mood changes, such as feeling irritable or anxious

Antibiotics

If your labyrinthitis is thought to be caused by a bacterial infection, you will be prescribed antibiotics. Depending on how serious the infection is, this could either be antibiotic tablets or capsules (oral antibiotics) or antibiotic injections (intravenous antibiotics).

A number of antiviral medications are also available, but these are usually less effective than antibiotics and may have a limited effect in speeding up your recovery time. Your GP may therefore feel there is little benefit in prescribing you this type of medication.

When to seek further advice

Contact your GP if you develop additional symptoms that suggest your condition may be getting worse. If this happens, you may be admitted to hospital. These symptoms include:

  • mental confusion
  • double vision 
  • weakness or numbness in one part of your body
  • a change in the way you usually walk

Also contact your GP if you do not notice any improvement in your symptoms after three weeks. You may need to be referred to an ear, nose and throat (ENT) specialist.

Chronic labyrinthitis

A small number of people experience symptoms of dizziness and vertigo that last for many months and, in some cases, years. This is sometimes known as chronic labyrinthitis. 

The symptoms of chronic labyrinthitis are not usually as severe as when you first get the condition, although even mild dizziness can have a considerable impact on your quality of life, employment and other daily activities.

Vestibular rehabilitation therapy (VRT)

Vestibular rehabilitation therapy (VRT) is an effective treatment for people with chronic labyrinthitis. VRT attempts to "retrain" your brain and nervous system to compensate for the abnormal signals that come from your vestibular system.

VRT is usually carried out under the supervision of a physiotherapist and involves a range of exercises designed to:

  • co-ordinate your hand and eye movements
  • stimulate sensations of dizziness so your brain starts to get used to disruptive signals sent by your vestibular system and then ignores them
  • improve your balance and walking ability
  • improve your strength and fitness

The Brain and Spine Foundation is a UK charity that has more information about vestibular rehabilitation on its website.

You can ask your GP to refer you to a physiotherapist or you can pay for private treatment. If you decide to see a private physiotherapist, make sure they are fully qualified and a member of a recognised body, such as the Chartered Society of Physiotherapy (CSP).

Physiotherapists who are members of the CSP will follow high standards of professional practice and have a good level of knowledge and skills. Go to the Physio First website, which lists qualified members, to find a private physio in your area.

Not all physiotherapists have training in VRT, so you need to make it clear you require this type of treatment before making an appointment.

Page last reviewed: 25/02/2013

Next review due: 25/02/2015

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The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Tullibardine11 said on 02 March 2014

Woke up early hours, turned over in bed and twisted back and neck which resulted in the room spinning out of control, I have never passed out but it felt like I was going to! Could not stand up for a while and had a terrible upset stomach immediately after the room spinning stopped, purely as a result of the fear of the experience. By the time I went to the doctors, I was fine and it was diagnosed as a one-off incident. Later that afternoon, the dizziness returned with a vengeance, where I felt I was going to fall and was made worse if looking down or up, the cause seemed to be the base of my neck, so much so, that every time I turned over during the night, I was woken up with dizziness. On the 4th day, went to work but really off-balance and thinking unclearly and had to really concentrate on walking and ended up coming home and back at doctors where diagnosis was made. For the first week, take it easy with rest, when able to, go for short walks and try not to get depressed by the whole thing! You may need a second week off but most people seem to recover within a fortnight.

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Sarann2012 said on 10 November 2012

I have suffered with Labyrinthitis on and off since I was 14, although attacks were many years apart. However, in the last few years I have had more attacks, some severe. The last attack was just after Christmas 2011, and it has never gone away.... most days are tolerable... in that I know I must not look up at high shelf level... but I never know when I am going to wake up with a bad day... today for example.

When I went to my GP a few years ago, I was told they could not treat it and that I would just have to wait for it to get better on its own. My daughter also suffers with it (aged 13) and she was also told the same thing by her doctor, although she was given anti-sickness tablets, which were of no use.

I cannot believe that there is NO treatment.... it is a very frightening thing to experience, and something that hangs over my head constantly because of not knowing when it is going to happen.

I am wondering whether the attacks are brought on by dehydration???? does anyone know if this is the case? I have tried to find the reason why they occur, but cannot find any common factors.

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annefletch said on 02 October 2011

I am a front line NHS worker, returning to work after 4 months sick leave due to labyrinthitis. Please note that betahistine, which was prescribed for me, delays the brains ability to compensate for the damage done by the labyrinthiytis ( source; physiotherapist treating me with VRT). After consulting the person who prescribed it ,which is very important, I could then have stopped taking it much earlier.

I also would suggest that patients ask to go onto the physiotherapy waiting list for VRT early on in their illness. If they are improoving/well they can always cancel the appointment , but there might be an 18 week waiting list ( NHS providers locally I spoke to varied between 4 &12 weeks) . I hope this information is helpful to other sufferers.

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