Back in 2017 Nugent took some time away from the BBC programme in order to recover from a bout of labyrinthitis, an inner ear infection which caused her to suffer from dizziness and struggle with her balance. Taking to Twitter to explain to viewers why she was not seen on the programme she shared: “Thanks for all the lovely messages. I’m off work for a bit with labyrinthitis. Will be back just as soon as the room stops spinning.”
Labyrinthitis affects the delicate structure deep inside the ear known as the labyrinth, causing it to become inflamed.
The NHS explains that the fluid-filled channels of the labyrinth are known as the vestibular system and are connected at different angles. This fluid moves with your head, telling the brain how far, fast and in what direction the head is moving.
This then allows the body to balance properly. The vestibular system works in a similar way to a stereo, with your left and right ears sending separate signals to your brain. If one ear becomes infected, these signals become out of sync, which confuses your brain and triggers symptoms such as dizziness and loss of balance.
The labyrinth also contains a small, spiral-shaped cavity called the cochlea. It sends sound waves to the language processing areas of the brain. Inflammation can disrupt this function, leading to hearing loss.
With lots of disruption potentially being caused by infection, the condition should be taken seriously and treated as soon as symptoms are noticed.
Around half the cases of labyrinthitis are thought to be caused when a viral infection of the chest, nose, mouth and airways spreads to the inner ear.
However, other cases of labyrinthitis can be caused by a bacterial infection. Although more rare in comparison to viral infections, it can be far more serious. The NHS notes that bacteria can enter the labyrinth if the thin layers of tissue that separate the middle ear from the inner ear are broken. This can happen if an individual develops a middle ear infection or an infection of the brain lining (meningitis). Bacteria can also get into the inner ear if you have had a head injury.
The most common symptoms of the condition include dizziness, hearing loss (from mild to total loss of hearing) and vertigo – the sensation that you, or the environment around you, is moving.
For some individuals these symptoms can become severe, with people unable to remain upright. Other possible symptoms of labyrinthitis include:
- A feeling of pressure inside your ear(s)
- Ringing or humming in your ear(s) (tinnitus)
- Fluid or pus leaking out of your ear(s)
- Ear pain
- Feeling sick (nausea) or being sick
- A high temperature (fever) of 38C (100.4F) or above
- Changes in vision, such as blurred vision or double vision
- Mild headaches.
These symptoms can start suddenly and may seem worse as the day goes on. It is important to note that the NHS reassures individuals that they will usually get their balance back over two to six weeks, although it can take longer.
When experiencing symptoms such as dizziness and vertigo, there may be another underlying cause. Due to this, it is important for individuals to get a professional diagnosis from their GP.
When seeking medical advice a GP may carry out the following tests:
- A physical examination – you may be asked to move your head or body and your ears will be checked for signs of inflammation and infection
- Hearing tests – labyrinthitis is more likely if you have hearing loss.
- Eye tests – if they are flickering uncontrollably, it is usually a sign that your vestibular system (the body’s balancing system) is not working properly.
It may be that an individual is suffering instead with a condition known as vestibular neuritis, a similar condition that causes inflammation of the vestibular nerve – the nerve in the inner ear that sends messages to the brain.
The symptoms of vestibular neuritis and labyrinthitis are very similar. However, the key difference is that if hearing is affected it can be certain that labyrinthitis is the cause.
This is because inflammation of the labyrinth affects hearing, while inflammation of the vestibular nerve does not.
Doctors can usually safely assume that labyrinthitis is the result of a viral infection (more common) unless there is strong evidence to suggest otherwise. Once a diagnosis is reached treatment can be recommended.
Labyrinthitis is usually treated using a combination of self-help techniques and medication. Medication is used particularly for those who are suffering with dizziness and a loss of balance.
Medication such as benzodiazepine or antiemetics (vestibular sedatives) are often prescribed by the NHS. The first of which reduces activity inside the central nervous system and the second to target vertigo symptoms and side effects such as nausea.
There are also numerous self-help techniques provided by the NHS. These include:
- Drinking plenty of fluids to avoid dehydration
- Resting in bed
- Avoid falling and injuring yourself
- Avoid alcohol
- Avoid bright lights
- Try to cut out noise during an attack of vertigo.
A small number of people experience dizziness and vertigo for months or even years. This is sometimes known as chronic labyrinthitis. For this, vestibular rehabilitation therapy (VRT) is an effective treatment for people with chronic labyrinthitis. This aims to “retrain the brain” and nervous system to stop symptoms such as dizziness.
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