Labyrinthitis is an inflammation in the maze, usually caused by microorganisms such as bacteria or viruses. Its correct name is actually labyrinthopathy, which corresponds to labyrinth diseases. It is a picture of alteration of the perception of movement, whether due to imbalance, sensation of movement of the environment, sensation of floating, rotational sensation? of Otorhinolaryngology.
Labyrinthitis may manifest subtly or even in conditions where the person is unable to perform activities or to move around. Generally speaking, it is not a serious health problem, but can be quite debilitating in some cases.
Causes of Labyrinthitis
There are numerous factors related to maze diseases, some examples are:
- Carbohydrate overeating;
- Stress;
- Sleep deprivation;
- Metabolic conditions such as decompensation of diabetes, thyroid, cholesterol;
- Use of excess medications;
- Suspension of abruptly controlled medications;
- Ingestion of alcoholic beverages (which may be a labyrinth stimulant);
- Head trauma;
- Airway infections and / or ear manifestations;
- Sudden change in position, benign paroxysmal positional vertigo, one of the main causes in young patients;
- Osteoporosis;
- PMS;
- Climacteric;
- Stroke (stroke).
Finding the cause of the problem will be essential to indicate the best treatment for labyrinthitis, taking into account the particularities of each case.
Risk factors
Jeanne Oiticica, Otorhinolaryngologist and Head of the Tinnitus Research Group of the Clinical Hospital of the USP School of Medicine, points out that labyrinthitis can occur in any age group, including children and / or babies, but is less frequent in this age group.
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It is much more common in the elderly because of system aging, associated comorbidities and medications. Among adults, women are the most affected, especially due to lifelong hormonal fluctuations ?, says.
They also belong to the risk group:
- People aged 40 to 50 years;
- Patients who have had ear surgery;
- People who have been victims of head trauma.
Symptoms
Larissa highlights how the main symptoms of labyrinthitis:
- Inability to walk straight
- Sensation of imbalance
- Floating sensation
- Inability to move like turning over in bed, getting up
- Nausea or vomiting (accompanying other symptoms as above);
- Auditory sensations such as ear pressure or a change in perception of sound (tinnitus).
All of these symptoms, the otolaryngologist explains, may remain for seconds or last for days.
Jeanne points out that dizziness can be described by the patient in many ways, including dizziness, instability, visual darkening, spatial disorientation, hollow head, imbalance. It may or may not come with other symptoms such as nausea, vomiting, neck pain. There may be tinnitus and associated hearing loss, as well as a blocked ear sensation. Dizziness can only occur when lying down and getting out of bed, etc., he adds.
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Still according to Jeanne, labyrinthitis is not a serious problem, but can be quite debilitating in some cases. Depending on the person, labyrinthitis can lead to falls, loss of consciousness, restriction of activities, reduced quality of life. There are cases where an acute crisis of vertigo may be related to a stroke or stroke, then it is serious, but this is not the most frequent ?, explains.
Diagnosis
Jeanne explains that the diagnosis is based on the clinical history described by the patient and can be complemented by tests, including blood, imaging, hearing electrophysiological, labyrinth tests, among others, all according to clinical suspicion.
Larissa points out that it is always necessary to rule out central causes, ie the brain, such as strokes, injuries, tumors. There are tests that delineate for central (brain) or peripheral (labyrinth) causes, as well as pinpoint which branch of the vestibular nerve may be compromised (nerve responsible for bringing information from the labyrinth to the brain). Many times we must use imaging exams for better clinical clarification ?, highlights.
Treatment
The treatments available for labyrinthitis are divided into: symptom treatment, root cause treatment, maze rehabilitation and drug treatment.
Symptom Treatments
Jeanne explains that there are several non-drug treatment strategies, such as canalicular replacement maneuvers, vestibular rehabilitation, physical therapy, among others.
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Regarding medications, Larissa points out that there are medications to reduce maze stimulus (labyrinth depressants) that reduce symptoms, as well as medications that reduce nausea and vomiting.
Cause Treatments
Treatments are as varied as possible depending on the cause of the labyrinth disease. A very common labyrinth disease, according to Jeanne, is Benign Paroxysmal Positional Vertigo (BPPV), which has sudden episodes of vertigo, the sensation that the environment is spinning, and that lasts up to one minute.
The labyrinth has small crystals of calcium carbonate (very delicate stones) that are in a bag in the center of this organ and are essential for the proper functioning of the ear. But when these crystals detach from the surface, they float, and then BPPV ?, says Jeanne. "In this case, the treatment is based on the canalicular replacement maneuver, made in the office by the otoneurologist," he says.
However, Jeanne points out, there are other types of labyrinth disease and treatments can vary greatly: restrictive diet of certain foods, hydrotherapy, vestibular rehabilitation (kind of exercises to strengthen the maze), introduction of medicines to the maze in some cases, withdrawal of medicines. causing labyrinth disease, physiotherapy, sensory substitution, among others.
Maze Rehabilitation
Larissa explains that maze rehabilitation consists of specific and repetitive exercises designed by a physiotherapist or speech therapist, and aims to improve tolerance to change of position. "Is there movement improvement, gait improvement, tolerance to simple movements, such as getting out of bed or extending clothes?" functions that, for the patient with unstable maze, might be impossible. Do these exercises help to return to daily activities earlier?
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Otolaryngologist Jeanne adds that maze rehabilitation is always directed on a case-by-case basis. It is never the same strategy for each and every patient. It depends on the type of clinical complaint presented, if acute, if chronic, what are the restrictions and disabilities presented, what has residual function of the maze, what can be recovered ?, says.
Medicines
Larissa explains that acute phase medications (cinnarizine and flunarizine, usually limited to up to one week) and medications to prevent further episodes (ginko biloba and betahistine - these for prolonged use) can be used.
In addition, to reduce nausea and vomiting, medications such as dimenhydrate, meclizine, ondansetron and corticosteroids can be used. Depending on the intensity of the symptoms venous medications and hydration or even hospitalizations are necessary ?, highlights Larissa.
Remembering that patients with difficult control, rehabilitation has excellent results. In addition, several foods stimulate the maze, such as coffee, teas, carbohydrates and alcoholic beverages, so until restoration of balance, it is important to reduce intake ?, adds the otolaryngologist.
It is noteworthy that, in the case of labyrinthitis, excessive medications can cause excessive sleepiness and reduced reflexes and concentration. "Therefore, only prescription drugs," warns Larissa.
The greatest risk of self-medication, as Jeanne points out, is worsening symptoms of labyrinth disease. Besides not improving or chronifying the problem without the proper solution of it. Another highlight that should be given is the side effects arising from self-medication, including Parkinsonism, headache, drowsiness, hand and extremity tremors, increased blood sugar levels, among others ?, explains the doctor.
Living with the disease
Larissa explains that emotional stability, quality of sleep, balanced diet and the control of chronic diseases are related to the reduction of dizziness. • In chronic labyrinth disease conditions, follow-up with an otolaryngologist is of paramount importance. It's always good to reinforce that good emotional balance greatly reduces the chance of dizziness, or makes it lighter, he says.
In this sense, there are some practical tips that help the person to live the labyrinthitis as best as possible and to avoid dizziness:
- Have a healthy diet, avoiding, for example, processed foods (which contain excess salt), sugar, trans fats and fast-absorbing carbohydrates;
- Do not do prolonged fasting;
- Check health regularly;
- Do not use prescription drugs;
- Do not smoke;
- Avoid alcoholic beverages;
- Do physical activity regularly;
- To care for a good sleep, using, for example, comfortable clothes, quality pillow and mattress etc .;
- Do not use drugs;
- Drink plenty of water;
- Avoid stress as much as possible;
- Look for ways to control anxiety.
An important piece of information, according to otolaryngologist Larissa, is that dizziness will never be forever, however there is no permanent permanent cure. "The maze itself with the aforementioned treatments usually restore balance," he concludes.
You now know that labyrinth disease, popularly called labyrinthitis, can produce very unpleasant symptoms, but it is not usually a serious disease. Still, it should be closely monitored by an otolaryngologist who will indicate the best form of treatment.
Labyrinthitis (Vertigo) : Causes, Diagnosis, Symptoms, Treatment, Prognosis (March 2024)
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