Labyrinthitis
 

Anyone have any experience of this horrible condition ?

Yep - 2-3 times. It's pretty frightening when it first happens but it (usually) soon clears up; well, it did in my case. My doc didn't prescribe anything and although I had a couple of days off work my AME wasn't concerned. I believe the symptoms can vary. Mine were the same each time - room spinning when laying in bed. Standing up I was OK. A colleague had it and his symptoms were worse when upright; he couldn't drive as each time he turned his head everything went bananas and he suffered bad "seasickness". Again, it cleared up fairly rapidly.

My GF currently has it, she has some other long term conditions which make it even worse. It actually affected her eyesight at it's worst last week, pupils constantly moving making it near impossible to focus. Dr has told her 4 - 6 weeks to clear completely, improvement expected within 2 weeks.

Apparently the test which makes it obvious is have the patient follow the movement of a pen in front of the eye whilst observing and jerkiness of pupil motion.

If you have it you have my sympathy!

A friend of mine has it at the moment.....he's been given sea-sickness pills for medication!

I had it last year. I spent two weeks in bed, not a barrel of laughs. Cleared up in about a month.

Sat reading a magazine at teatime. (about 8 years ago) Suddenly felt as if I was going to faint. Had to close my eyes to stop the room spinning fast, then started reaching, but not being sick and went almost to unconsciousness and rolled sideways onto settee.

Wife phoned emergency doctor who said "Bring him to surgery". 'Er indoors told him that it was impossible to move me. He arrived within ten minutes and immediately suggested Labyrinthitis.

Gave me an injection and tablets to take and within about 8 hours I was fine again. Took further tablets for a couple of days. I felt that I was dying and that it wasn't too bad as I'd had a good life.

Lancelot,

Any idea what was in the injection and tablets ?

Coincidence! I have just finished a bout of it for the third time. Not so bad this time but getting out of bed last Friday, I fell A over T and that was it. Back to bed with horrific roomspin.

just like being pissed without the alchohol!!

It would almost certainly have been Cyclazine (not sure about spelling) in the injection and probably in the tabs. The injection would have stung like a b*stard if so!

I'd be 95% certain they would be Stemetil (otherwise known generically as prochlorperazine). Nothing works better in acute labyrinthitis.
NOT safe, however, in anyone proposing to drive or fly, due to the likely sedative side effects (actually, a good effect if you are suffering the misery of labyrinthitis ! ).

One day, when I'm too old to be prosecuted, I'll post the funny? e-mail I sent a pal about passing a Class I at LGW while suffering raging vertigo.


I was in the second day, and had observed a 27 second swirling period after sitting up -- or lying down -- before everything stabalized. I used this period to save the day. How I got through this medical was the suff of a Brian Rix farce, and at one point I almost hung on the head-honcho's lapels to stop falling over, but I wobbled out with that magic piece of paper with a week off and 3 weeks of refrshers before Tech school. I was better in three days, and would have lost the job because medicals were being booked weeks ahead in that CAA to JAA transition.

No, I didn't drive there, and had to be helped out of the car.

labyrinthitis vs BPV
 

Chaps & Chapesses

Diagnosis of vertiginous disorders is an area poorly understood and poorly performed by most general practitioners. AMEs might be a bit better but I wouldn't bet on it.

The commonest misdiagnosis is confusion between labyrinthitis (which overlaps with a closely related condition called vestibular neuritis) and benign positioning vertigo (BPV). There's a lot of small print but basically BPV is vertigo only precipitated by change in head position, most commonly lying down, lasts for <60sec total vertigo even if you feel sick for longer, and after a while at rest you feel perfectly fine. Labyrinthitis is vertigo lasting for days, worse with any head movement but not completely resolving at rest, with a slow recovery over weeks to a month or three depending on severity and vestibular demands (ie you might be fine walking but in bumpy IMC with a partial panel you might as well get out and walk).

The two conditions require completely different treatments. BPV, which is really common, doesn't need drugs.

There are a number of other vestibular disorders that are less common, not detailed here. This obviously includes barotrauma which should be obvious (onset with change in pressure).

Coming back to my original point, skill in this area is really sparse and confined to a proportion only of ENTs and neurologists, few GPs and virtually no-one else. So if it matters to your professional career get a serious opinion. Often it doesn't matter - all gone long away - in which case fine. Sorry to sound discouraging and I don't usually bother interfering in this forum, but there seems to be some problems here.

For your reference I often suggest people go to emedicine for their well written reviews, and would include these:

http://www.emedicine.com/NEURO/topic411.htm

http://www.emedicine.com/emerg/TOPIC637.HTM

Thanks for that, Omniplasm.

After seeing my GP, two ENT'S and two Neurologists the most popular opinion is that I have Vestibular Neuritis, briefly, I have a feeling of falling, always to the right, sensation of fullness in my ears with clicking when swallowing, alternating from one ear to the other.

But, no Nausea, no hearing loss.



Have had a Sinus Cat scan, Mri of the brain, hearing tests etc.. all negative.

This all started after a very mild sinus infection and has been ongoing for 3 months.



Today I had a Mri taken of the inner ear, hoping that will show something as I have had some ear pain as well lately.

After reading your linked article, I am going to try to persuade my ENT tomorrow to try a 3 week course of Methylprednisolone starting at 100 mg, tapering down to 10mg.



They have ruled out BBPV, my next stop is a Neuro otologist.

As you said, the only constant is the lack of knowledge on this disorder.



Very frustrating and discouraging:ugh:

Any other suggestions would be welcome. Thanks again.

Labyrinthitus
 

Had a bad episode of Labyrinthitus about 7 years ago which sent me and the house into the worst spin imagineable. Wife, who used to be a nurse, called doc who injected Stematol ( I think ) to stop the sickness. When I did the eye test to follow his hand he called his colleague and said "Wow, Look at this " I think my eyeballs were going walkabout.
Couldn't see for a couple of days and had to be spoon fed for about a week.
The worst thing is that docs can do very little for the condition. My quack was worse than useless by not accepting that it can last more than the six weeks his textbbook said.
About nine months later, I got my licence back.

Installed MS Flight Sim ( sad, I know ) to get hand/eye co ordination back, and bought myself a mountain bike to explore the flight envelope, as it were.

Regards

http://avanimation.avsupport.com/gif/Rollsby.gif

<<Lancelot, Any idea what was in the injection and tablets ? >>

The tablets were Stematil, but no idea about the injection as I was "out of it". The injection may have been the same in liquid form as an immediate treatment into the blood stream.

Thanks for that.

Now, my ENT is mentioning the possibility of MS despite negative results on my MRI of the brain.

Very discouraging !

Yep, other possibilities are MS or Meniere's disease.

Learn about all medical conditions on www.patient.co.uk

Billed as the same resource used by your GP. It is very useful.

Thanks Omni, very interesting. s'what this forum's all about.

Sounds like I was very lucky to only have BPV, but when I first sat up it was as though my bed had been trown round the room. As I mentioned, 27 seconds was almost perfectly timed every transition.

Stilton I've been suffering from vestibular neuronitis for nearly 5 months now. Conditions are slowly getting better but I now find I get really tired around 5pm.
I've been to see 2 ENT docs, a neurologist and an audiological scientist and it seems that the condition is not particularly well understood especially if symptoms persist for over 3 weeks.
Best advice I can give is try and relax as the symptoms are made worse with stress. Easier said than done I know.
I'm also trying to keep fairly active which helps retrain the brain (cycling etc).
Good luck

When I eventually got back to work after my bout of Labyrinthitus, it turns out the company had an AME on the staff who had made a study of RAF pilots in centrifuges ( Spelling? ) etc.
He explained the 'healing process' is similar to a child learning how to stand up for the first time. If you watch a toddler falling over while he learns to walk upright, all he is doing is educating his balance mechanism. If you have had a bad bout of labyrinthitus you have to re educate your brain to get your balance back. Do not be afraid of falling over ( a child isn't ) Don't be afraid of 'exploring the envelope'. You might feel nauseous but you must stretch your brain and balance mechanism deliberately. Similar to having a broken leg, you have to exercise it to get the strength back.
As No1Mutt says, get the bike out. Use exercise to get the strength back.

I have heard of other sufferers who have gone down the Alternative Therapy route. I tried Acupuncture as conventional medicine usually cannot help. I found that, while it was OK experience, it did NOTHING for the condition. One other who tried homeopathy looked a physical wreck. I am convinced that exercise is the best way.

Regards

I had a mild attack a few years ago. Ironically it started in a hotel in Chicago when I was returning to the UK after checking out flying schools for Ab Initio training and I had to postpone my appointment for the initial class 1 medical.

Fortunately it never really got beyond a slightly dizzy / nauseous phase. I also found that bright lights were just a bit "too bright" and this seemed to increase the feeling of nausea. My GP diagnosed a inner ear infection and prescribed Stemetil tablets. It cleared up in about 10 days so I guess it was BPV and not labrynthitus. Should have asked more questions.

When I finally made it to the AME he made me do a lot of balance stuff (on one leg / eyes closed / tip of finger to nose etc) got the medical ok.

As I found out much to my dismay last week when seeing a supposedly ‘Top ENT Surgeon’, very little is actually known about inner-ear disorders.

I will state the obvious, in the hope that it might help some here:

Put the term “vestibular rehabilitation exercises” into Google – that could be a start.

Secondly, bear in mind that hard wax and skin-based deposits can get stuck deep in the ear and actually cause balance problems – these may not be immediately apparent to the Doc when they use the Otoscope. Also bear in mind that there are numerous reports worldwide to suggest a fair proportion of GPs are less-than-adept at interpreting the visual signs illustrated by the otoscope.

edit - Please note the point made below by Jimi re: rehabilitation exercises. Check them out for the sake of reference, but I suspect it's best to get a good diagnosis before starting them - as suggested.

I have also been suffering with this horrible condition for three months.

For what it's worth - do not see ENT they only know the basics. You need to see a neurotologist who will specialise in the balance problems caused by inner ear disorders. You should not do any rehabilition exercises until you have a correct diagnosis, as some conditions can be made worst. When you have had a full set of balance tests carried out then they will give you some exercises based on your particular problem. ie. which ear etc.

Hope this helps.

Thanks very much for the replys.

Latest medical opinion is not MS but still vestibular neuritis.

Any other information most welcome.

As has many of you have said the one thing consistent about this condition is the lack of knowledge on it.

Take this with a pinch of salt, but I wonder if there have ever been any studies comparing incidence of labrynthitis-type disorders in pilots against non-pilots? Or indeed, "shift workers" against 9-5 workers?

I don't think I have vestibular neuritis but some other inner ear problem. I often get sensations like I am rocking, like being in a boat. Had this for about 3 and a half years. Been putting up with it but should probably go see the doc. Reason I've not been is that I have heard that any slight mention of ear/balance problems on med records and the CAA won't ever let you fly. Is this correct? I so badly want to be a pilot that that is why I've not got it checked.

(Sorry for the sligh off-topic)

Andy S

Considering balance issues can have a multitude of causes, I post these links out of interest. As always, all caveats apply - make sure you see a decent practitioner.

http://www.pprune.org/forums/showthr...08#post1794508

http://audiology.advanceweb.com/edit....aspx?cc=93837

Great quote from the 1st link:Try Google for "jaw clenching, stress, imbalance" - a search string along those lines.

This info is no substitute for that of a Professional!

Vestibular Neuritis
 

Don't like to beat a thread to death but trying to get as much information / experience of this problem by others as I can as my doc thinks this is what has me 'unbalanced'

Anyone had / have this and found a real remedy, and how long did you have it?

Stilton - have you had an appointment with a Neuro-otologist yet?

If you see one with the right kit, they'll be able to diagnose you in an afternoon.

If you can get to London, the place you want to go is the Royal Ear Nose + Throat Hospital in King's Cross. Having been checked out there myself, it made me realise that there's absolutely no place for anyone other than the very top-flight pro in getting a diagnosis of an inner ear issue.

If you're based in England, get your GP to refer you to the Royal ENT pronto - it'll put your mind at rest, I promise.

Yes, seen one of those, had every balance test /mri scan there is done (all negative) he says it is VN due to a virus and all I can do is wait it out, must be other things to try methinks..

Stilton
In my experience, ( acute viral Labyrinthitus ), that wait could be up to a year. Even after a year you will have doubts about the integrity of your balance mechanism which will largely be a confidence thing. By now you are probably losing any faith that you had in the medical profession. I know I did, when after about 2 months, my GP pushed his chair back and said 'you probably know more about it than I do'

Probably not what you want to hear.

It will get better.

You are correct about losing confidence in Doctors, but I still think there must be something I have not tried.

Thanks for the encouragement.

Hi Stilton

I came down with this awful condition in August last year. Likewise it was cause by a virus which came on the back of a severe bout of gastro enteritis.
I had the feeling like I was permantly drunk with the room spinninng etc along with screaming tinnitus which appeared after about a month of being ill.

I also had a aimilar experience with GP's, I saw most of the ones at my local practice before I was referred. Two of the doctors thought I had Meniere's disease (which I am sure you have heard about) which basically scared the S**t out of me and added to the stress and misery that I was suffering.

Eventually I got to see a consultant Otolaryngologist (one of the best in the country and an authority on Menieres ).

He was quickly able to dismiss Menieres. He ordered an MRI, the usual blood tests, hearing tests and all those balance tests which I am sure you have done, and had my eyes looked at using infra red whilst having hot and cold air pumped into my ears. The outcome of these tests was that the virus had partially damaged my right hand inner ear, which is why my balance hadn't recovered.

The damage could be compensated for and my sense of balance retrained with vestibular rehabilitation therapy, so I was directed to the practice physiotherapist.

This consisted of various exercises which involved moving the head from side to side and up and down, sometimes with eyes closed, and an exercise which involved focussing on a fixed point whilst moving the head from side to side, the idea being to re educate the link between your inner ear and your eyes. The physio also recommended playing video games as an additional means means of re educating the visual/balance mechanism.

These exercises took about 10 days to sort my balance out and the symptoms gradually faded out apart from the tinnitus.

Did your consultant mention vestibular rehabilitation therapy?

In total I was ill for three months, then had to go a month symptom free before the CAA would entertain reinstating my medical, subject to satisfactory medical reports. Which they did the same day they recieved said reports!:D

The specialist said the condition was particulary sensitive to stress and was one of the reasons I was ill for so long.

He anticipated that in 6-8months it would all be a unpleasant memory. He also added that my ears should be protected wherever possible.

From what I have read it varies how long it takes to recover from viral labrinthitis/vestibular neuronitis, ranging from a couple of months to a couple of years.

My advice to you is the advice the Physio gave me once my recovery was underway which was "get on with life" by which he meant get back to doing the things you used to do as soon as possible.

As for me six months on I'm still ok, I still have the tinnitus in my right ear but it has calmed down somewhat and no longer keeps me awake at night. Will it ever dissapear? I hope so as silence truly is golden, and it is a constant reminder of what was the most unpleasant experience in my life.

Hope that is of some interest. Feel free to PM me if you have any questions.

I sincerely wish you a speedy recovery.

Regards

BTT

Thank you for your detailed and comprehensive answer BTT.

It sounds like you have had more than your fair share of misery with Labyrinthitis, glad to hear you are much better, I think the Tinnitus will go away soon.

My symptoms have been a little different than your experience, no nausea, and not real dizziness per se, just a feeling like I am going to fall over (always to the right) and a general unsteadiness, rather like being on a ship rolling in a heavy swell.This is nearly always most pronounced while walking, less while standing and almost unoticeable whilst seated.

Acommpanying this has been an intermittent sensation of 'fullness' in my ears and nose, rather like being unable to clear out your ears on descent with the usual clicking sounds.

I have seen the top Neurotologist in my area and have had every test that there is, all negative, and in fact they say both ears are fine.

They put me on a long course of anti-viral medication which did nothing and am now on a week long course of steroids, we will see..

I have been doing the 'vestibular' exercises at home and the gym (with some strange looks) nothing has made any difference yet.

I wonder how much good the VRT therapy wil do while I still may have the virus that caused this 'vestibular neuritis'

Unable to work of course :uhoh:

Thanks again for your reply

Hey Stilton,
Have been suffering from the same condition for over 5 months now. Looks like I won't be returnibg to work for another month at least.
Whilst I am still not 100%, my days of feeling better are becoming more frequent than the days of feeling crook.
I have had quite a lot of symptoms including tiinnitus, eye twitching, a spaced out feeling, and bouts of vertigo. My only recommendation would be to relax and accept the crazy symptoms. Unfortunately you won't find many answers to a lot of what's going on.
It truly is a very frustrating condition in both it's symptoms and the way it lingers for so long. I tried to find answers from doctor friends and via the internet and it just increased my anxiety making conditions worse.
There's one thing for sure and that is stress makes any condition worse.
Good luck mate.

Mutt makes an important point regarding stress / anxiety. For any kind of inner ear problem, the absolute worst thing you can do to exacerbate it is let stress get to you. From what I understand (I'm not a health pro), any kind of tension around the TMJ joint and its associated muscles will potentially exacerbate your symptoms.

I totally agree with you on the stress issue, it certainly seems to be in lock step with my state of mind.

I am trying accupuncture and balance exercises as well as seeing a Chiropractor now, sometimes it helps, this is an incredibly frustrating problem with no clear remedy however.

If I find anything that works I will pass it on in this forum and would you mind doing the same ?

Thanks for the encouragement and kind words Mutt and Wg7

I wish you all the very best,

Have you undergone electrocochleaography yet? Forgive me if I'm stating the obvious. My GP says it's a very useful test to have for diagnosing inner ear issues. It's something I underwent in investigating my suspected inner ear issue.

It might be useful if you were to list all the test procedures you've been through, Stilton - that way we won't have to tread over old ground.

Edit - have you thought of trying a course of Betahistine tablets? Although the drug is associated as a treatment for Meniere's, it's designed to improve blood flow in the inner ear. I have heard it suggested that it *could* have uses treating people exposed to loud trauma, if given immediately afterwards. The side effects of Betahistine are supposed to be very mild, and Meniere's sufferers take it long term. Could be worth investigating?...

I am not familiar with the Electrocochleaography test although it may well go by another name on this side of the Atlantic

Tests performed so far:

Cat scan of the sinuses.

Mri of the Brain

Mri of the inner ear

Mri of the spine and upper neck

Nystagmus testing for eye tracking, numerous balance tests, including wearing what looks like a snorkelers mask with individual eye covers that are alternately closed and opened and also with both covers closed, moving ones head with left and right, up and down with eyes stationary then moving from side to side.

Blowing hot and cold air into each ear separately to induce dizziness while connected to electrodes, measuring recovery time ?

Standing on one foot/ both feet eyes open/ closed looking at balance.

Standing on a wobbly pillow, eyes / open closed, measuring balance.

Numerous hearing tests in soundproof booth with beeps / words to repeat as they get softer.

Listening through deliberately induced static to hear sounds.

Blood test to investigate possibility of infection from Herpes 1 virus.

I do not have the names for all of these tests and may have forgotten some that were done.

Incidentally, all were negative and balance / hearing was 'normal'

Forgot to mention I tried a course of betahistine as well (without result ) although my Doc says my ears are 'perfectly normal'

Hey Stilton,

Don't know if it helps but I did sveral MRI scans and tests and the last test I did showed unilateral dysfunction which was called the Unterberger. It was the only test that shed any light on the situation.
Good luck