Labyrinthitis Health Dictionary

The ability to balance is essential for a person to stand, walk and run. Maintaining this ability is a complex exercise of coordination dependent on the brain, sensory and motor nerves, and joints. There is a regular supply of information to the brain about the positions of various parts of the body and it responds with relevant instructions to the motor parts of the body. Eyes, the inner ear, skin and muscles all provide information. The cerebellum (part of the brain) collates all the information and initiates action. Balance may be affected by disorders in the balancing mechanism of the inner ear (semicircular canals) such as MENIERE’S DISEASE, and in?ammation of the labyrinth (labyrinthitis). Infection of the middle ear, such as otitis media (see under EAR, DISEASES OF), can also disturb the ability to balance, sometimes accompanied by dizziness or VERTIGO. If the cerebellum is affected by disease – a tumour or a stroke, for example – the result will be faulty muscular coordination leading to clumsiness and the inability to walk properly.... balance

Vomiting means the expulsion of the STOMACH contents through the mouth. When the e?ort of vomiting is made, but nothing is brought up, the process is known as retching. When vomiting occurs, the chief e?ort is made by the muscles of the abdominal wall and by the diaphragm contracting together and squeezing the stomach. The contraction of the stomach wall is no doubt also a factor, and an important step in the act consists in the opening at the right moment of the cardiac or upper ori?ce of the stomach. This concerted action of various muscles is brought about by a vomiting centre situated on the ?oor of the fourth ventricle in the BRAIN.

Causes Vomiting is brought about by stimulation of this nervous centre, and in most cases this is e?ected through sensations derived from the stomach itself. Thus, of the drugs which cause vomiting, some act only after being absorbed into the blood and carried to the brain, although most are irritants to the mucous membrane of the stomach (see EMETICS); various diseases of the stomach, such as cancer, ulcer and food poisoning act in a similar way. Stimulation – not only of the nerves of the stomach, but also of those supplying other abdominal organs – produces vomiting; thus in obstruction of the bowels, peritonitis, gall-stone colic, renal colic, and even in some women during pregnancy, vomiting is a prominent symptom.

Severe emotional shock may cause vomiting, as may acute anxiety and unpleasant experiences such as seeing an accident, suffering severe pain or travel sickness.

Direct disturbance of the brain itself is a cause: for example, a blow on the head, a cerebral tumour, a cerebral abscess, meningitis. Nausea and vomiting are common symptoms that may arise from local disease of the gastrointestinal tract, but they are also associated with systemic illness – for example, DIABETES MELLITUS or kidney failure (see KIDNEYS, DISEASES OF) – and also with disturbances of labyrinthine function, such as motion sickness and acute labyrinthitis.

Treatment The cause of the vomiting must be sought and treatment directed towards this. Symptomatic treatment for vomiting can be dangerous since accurate diagnosis of the cause may be hindered. If antinauseant drug treatment is indicated, the choice of drug depends on the cause of the vomiting.

Granisetron and ondansetron are 5hydroxytryptamine (5HT3) antagonists valuable in the treatment of nausea and vomiting induced by cytotoxic CHEMOTHERAPY or RADIOTHERAPY and prevention and treatment of post-operative nausea and vomiting. Prochlorperazine is valuable in the treatment of severe nausea, vomiting, VERTIGO and disorders of the LABYRINTH of the EAR, although extrapyramidal symptoms may occur, particularly in children, elderly and debilitated patients.

Vomiting may occur after surgical operations and this is due to the combined effects of analgesics, anaesthetic agents and the psychological stress of operation. Various drugs can be used to prevent or stop post-operative vomiting.

Nausea and vomiting are common symptoms in pregnancy. Drugs are best avoided in this situation as they may damage the developing FETUS. Simple measures, such as the taking of food before getting up in the morning and reassurance, are often all that is necessary.... vomiting

A condition in which the affected person loses the power of balancing him or herself, and has a false sensation as to his or her own movements or those of surrounding objects. The power of balancing depends upon sensations derived partly through the sense of touch, partly from the eyes, but mainly from the semicircular canals of the internal EAR – the vestibular mechanism. In general, vertigo is due to some interference with this vestibular ocular re?ex mechanism or with the centres in the cerebellum and cerebrum (see BRAIN) with which it is connected. Giddiness is often associated with headache, nausea and vomiting.

Causes The simplest cause of vertigo is some mechanical disturbance of the body affecting the ?uid in the internal ear; such as that produced by moving in a swing with the eyes shut, the motion of a boat causing sea-sickness, or a sudden fall. (See also MOTION (TRAVEL) SICKNESS.)

Another common positional variety is benign paroxysmal positional vertigo (BPPV) caused by sudden change in the position of the head; this causes small granular masses in the cupola of the posterior semicircular canal in the inner ear to be displaced. It may subside spontaneously within a few weeks but can recur. Sometimes altering the position of the head so as to facilitate return of the crystals to the cupola will stop the vertigo.

The cause which produces a severe and sudden giddiness is MENIÈRE’S DISEASE, a condition in which there is loss of function of the vestibular mechanism of the inner ear. An acute labyrinthitis – in?ammation of the labyrinth of the ear – may result from viral infection and produce a severe vertigo lasting 2–5 days. Because it often occurs in epidemics it is often called epidemic vertigo. Vertigo is sometimes produced by the removal of wax from the ear, or even by syringing out the ear. (See EAR, DISEASES OF.)

A severe upset in the gastrointestinal tract may cause vertigo. Refractive errors in the eyes, an attack of MIGRAINE, a mild attack of EPILEPSY, and gross diseases of the brain, such as tumours, are other causes acting more directly upon the central nervous system. Finally, giddiness may be due to some disorder of the circulation, for example, reduced blood supply to the brain produced by fainting, or by disease of the heart.

Treatment While the attack lasts, this requires the sufferer to lie down in a darkened, quiet room. SEDATIVES have most in?uence in diminishing giddiness when it is distressing. After the attack is over, the individual should be examined to establish the cause and, if necessary, to be given appropriate treatment.

Vertigo and nausea linked to Menière’s disease – or following surgery on the middle ear – can be hard to treat. HYOSCINE, ANTI HISTAMINE DRUGS and PHENOTHIAZINES – for example, prochlorperazine – are often e?ective in preventing and treating these disorders. Cinnarizine and betahistine have been marketed as e?ective drugs for Menière’s disease; for acute attacks, cyclizine or prochlorperazine given by intramuscular injection or rectally can be of value. Research in America is exploring the use of virtual-reality technology to change subjects’ visual perception of the outside world gradually during several 30-minute sessions, helping them to adjust to the abnormal sensations that occur during an attack. Early results are promising.... vertigo

An antihistamine drug used to control nausea and vomiting due to travel sickness or to reduce nausea and vertigo in inner-ear disorders, such as labyrinthitis and Ménière’s disease. High doses are sometimes used to improve circulation in peripheral vascular disease and Raynaud’s disease. Side effects may include drowsiness, lethargy, dry mouth, and blurred vision.... cinnarizine

(vestibular neuritis) a condition characterized by the sudden onset of vertigo without hearing loss or other auditory symptoms (compare labyrinthitis). It generally lasts days to weeks and the cause is unknown.... vestibular neuronitis

A sensation of unsteadiness and light-headedness. It may be a mild, brief symptom that occurs by itself, or it may be part of a more severe, prolonged attack of vertigo with nausea, vomiting, sweating, or fainting.

Most attacks are harmless and are caused by a fall in the pressure of blood to the brain. This can occur when getting up quickly from a sitting or lying position (called postural hypotension). Similar symptoms may result from a transient ischaemic attack, in which there is temporary, partial blockage in the arteries that supply the brain. Other causes include tiredness, stress, fever, anaemia, heart block, hypoglycaemia, and subdural haemorrhage.

Dizziness as part of vertigo is usually due to a disorder of the inner ear, the acoustic nerve, or the brainstem. The principal disorders of the inner ear that can cause dizziness and vertigo are labyrinthitis and Ménière’s disease. Disorders of the acoustic nerve, such as acoustic neuroma, are rare causes of dizziness and vertigo. Brainstem disorders which can cause dizziness and vertigo include a type of migraine, brain tumours, and vertebrobasilar insufficiency. Brief episodes of mild dizziness usually

clear up after taking a few deep breaths or after resting for a short time. Severe, prolonged, or recurrent dizziness should be investigated by a doctor. Treatment depends on the underlying cause.... dizziness

The ear is susceptible to various disorders, some of which can lead to deafness. In rare cases, the ear canal, ossicles in the middle ear, or pinna are absent or deformed at birth. Rubella in early pregnancy can damage the baby’s developing ear, leading to deafness. Most cases of congenital sensorineural deafness are genetic.

Infection is the most common cause of ear disorders; it may occur in the ear canal, leading to otitis externa, or affect the middle ear, causing otitis media. This can lead to perforation of the eardrum (see eardrum, perforated). Persistent glue ear, often due to infection, is the most common cause of childhood hearing difficulties. Viral infection of the inner ear may cause labyrinthitis.

Cauliflower ear is the result of one large or several small injuries to the pinna. Perforation of the eardrum can result from poking objects into the ear or loud noise. Prolonged exposure to loud noise can cause tinnitus and/or deafness. Pressure changes associated with flying or scuba diving can also cause minor damage (see barotrauma).Tumours of the ear are rare. Acoustic neuroma is a noncancerous tumour of the acoustic nerve that may press on structures in the ear to cause deafness, tinnitus, and problems with balance.

In cholesteatoma, skin cells and debris collect in the middle ear. Obstruction of the ear canal is most often the result of earwax, although in small children, an object may have been pushed into the ear (see ear, foreign body in).

In otosclerosis, a hereditary condition, a bone in the middle ear becomes fixed, causing deafness. Meniérè’s disease is an uncommon condition in which deafness, vertigo, and tinnitus result from the accumulation of fluid in the inner ear. Deafness in many elderly people is due to presbyacusis, in which hair cells in the cochlea deteriorate.

Certain drugs, such as aminoglycoside drugs and some diuretic drugs, can damage ear function.... ear, disorders of

A ringing, buzzing, whistling, hissing, or other noise heard in the ear or ears in the absence of a noise in the environment. Tinnitus is almost always associated with hearing loss, particularly that due to presbyacusis and exposure to loud noise. It can also occur as a symptom of ear disorders such as labyrinthitis, Ménière’s disease, otitis media, otosclerosis, ototoxicity, and blockage of the ear canal with earwax. It may also be caused by certain drugs, such as aspirin or quinine, or may follow a head injury.Any underlying disorder is treated if possible.

Many sufferers make use of a radio, television, cassette player, or headphones to block out the noise in their ears.

A tinnitus masker, a hearingaid type device that plays white noise (a random mixture of sounds at a wide range of frequencies), may be effective.... tinnitus

n. inflammation of the ear. Otitis externa is inflammation of the canal between the eardrum and the external opening of the ear (the external auditory meatus). Myringitis is inflammation of the eardrum, often due to viral infection. Acute otitis media is inflammation, usually due to viral or bacterial infection, of the middle ear (the chamber lying behind the eardrum and containing the three bony ossicles that conduct sound to the inner ear). Symptoms include pain and a high fever. Treatment is with antibiotics and sometimes also by surgical drainage (*myringotomy). Secretory otitis media (or otitis media with effusion) is a chronic accumulation of fluid in the middle ear, causing hearing loss (see glue ear). Chronic otitis media (COM) is chronic inflammation of the middle ear associated with perforations of the eardrum and in some instances with *cholesteatoma. The treatment involves surgical repair of perforations (*myringoplasty) or removal of the air cells in the mastoid bone (*mastoidectomy). Chronic otitis media was previously known as chronic suppurative otitis media but the terminology was changed as the formation of pus is not an inevitable part of the condition. See also labyrinthitis.... otitis