The physical and psychological effects of chronic Labyrinthitis and Vestibular Neuritis
by Marian Groome BSC Psych (Hons), PTA
Labyrinthitis and Vestibular Neuritis (VN) are both conditions which affect the functioning of the inner ear. Both are usually caused by a viral infection but effect different parts of the Vestibular System. Labyrinthitis causes inflammation of the labyrinth, which resembles three intertwined semi-circular canals. These canals are filled with fluid and sensors, which detect rotational movement of the head and aid balance. Each semicircle is at a different angle to the others and is responsible for recognising a particular head movement, for example, side to side, up and down and tilting to either side. In addition, each semicircle contains hair cells that are activated when the inner ear fluid moves. When the head moves, these hair cells send nerve impulses to the brain through the ‘vestibulocochlear nerve’ (also known as the acoustic nerve) telling the brain about the position of our head and body. Vestibular Neuritis causes inflammation of the vestibular nerve, however causes the same symptoms as Labyrinthitis. Labyrinthitis and VN are thought to effect 1 in 10 people.
Labyrinthitis and VN symptoms usually begin very suddenly and can last between 2-6 weeks. Some people report that their symptoms disappear as suddenly as they started, however for many, recovery can be slow and frustrating. If labyrinthitis and VN continue past 2 weeks, it usually indicates that there is damage to either the labyrinth or the vestibular nerve as a result of infection. In cases such as these, Vestibular Rehabilitation Therapy is vital to get the vestibular system to compensate. Even with individuals who have a percentage of unilateral or bilateral hypofunction report increased independence and a decrease in symptoms, after practicing VRT for a number of weeks. Without this therapy, recovery can be bleak. Medication prescribed by general practitioners such as Stemetil or Serc, can actually be detrimental to recovery as they ‘dumb down’ the inner ear functioning in an attempt to curb the feeling of motion sickness. However, in doing so actually inhibit the brains ability to compensate fully on its own.
Symptoms of labyrinthitis and VN usually include, but are not limited to:
• Vertigo – a dizziness which feels like being drunk
• Spinning vertigo (dizziness like the room is spinning)
• Feeling like falling over or losing balance completely
• Chronic fatigue
• Low stamina and weak
• Mild confusion
• Slight memory loss
• Light headed, faint, woozy
• Sore, tired and strained eyes
• Motion intolerance
• Vivid dreams
• Disturbed sleep
• Blocked and popping ears
There are also a number of psychological symptoms individuals can experience when suffering with labyrinthitis and VN. Due to the isolation and the loss of self-reliance symptoms can cause, many people can experience depression. In addition, a large number of sufferers report experiencing panic attacks and anxiety combined with their labyrinthitis and VN symptoms. Some healthcare professionals suggest that this is a natural reaction due to worrying about falling over or feeling faint. However, one study conducted in 2003 by Nakagawa et al. showed that stimulation of the vestibular system was found to directly affect the amygdala gland, which triggers human beings fight or flight response, causing anxiety and panic attacks. Unfortunately, what this means for sufferers is that they have another element to deal with in their recovery.
Often the psychological symptoms of chronic illness can be overlooked as it can be normal to feel down when the body is sick. The five stage grief model, originally identified by Swiss-American psychiatrist Elizabeth Kübler-Ross in 1969, is a great indication of how people experience chronic illness. The stages are:
To make a full recovery from chronic labyrinthitis and VN symptoms it is advisable to perform daily Vestibular Rehabilitation Therapy exercises (as laid out by a professional physiotherapist after a consultation) and also attending talk therapy such as Cognitive Behavioural Therapy.