Labyrinthitis and vestibular neuritis
In both of these conditions patients present with continuous debilitating vertigo. Usually the actual vertigo or room spinning will last up to 24 hours but the disequilibrium, nausea and vomiting could linger for one to 2 weeks. The main distinguishing factor between the 2 conditions is presence of hearing loss with labyrinthitis. The exact cause or pathophysiology of the condition is not known. It is assumed to be inflammation of the inner ear in labyrinthitis versus inflammation of the nerves of balance in vestibular neuritis. It is actually uncommon for an MRI scan to demonstrate inflammation of the inner ear or the vestibular nerves for either condition. Because of the possible viral or inflammatory cause of the condition they are both treated with steroids and antivirals. In very rare cases labyrinthitis could be due to a bacterial pathogen. In these cases patients unfortunately develop complete deafness and debilitating vertigo. This condition could be seen in conjunction with meningitis or infection of the dura which is the sac covering the brain.