Select Page

Labyrinthitis

Jan 23, 2020

Labyrinthitis is inflammation of labyrinth with involvement of both vestibular and cochlear nerve in inner ear causing reduced hearing, vertigo and dizziness. It can be secondary to a viral illness like flu, measles, chickenpox, shingles, etc. or due to bacterial infection.

Medications:

For suspected bacterial infection

  • Tab. Moxikind-CV-625 (Amoxicillin 500 mg; Clavulanic acid 125 mg) 1 tablet thrice a day for 10 days.
  • Cap. Velgut (probiotic and prebiotic) 1 capsule twice a day for 10 days. 

For suspected herpes simplex (HSV) infection

  • Tab. Herpikind (Acyclovir 800 mg) 1 tablet four times a day for 5 days.

Supportive medications:

  • Tab. Flanzen (Serratiopeptidase 10 mg) 1 tablet thrice a day for 5 days to improve the antibiotic penetration into the infected tissues of middle ear.
  • Tab. Stugeron Plus (Cinnarizine 20 mg, Dimenhydrinate 40 mg) 1 tablet thrices a day to reduce nausea.

Steroid regime – Tab. Zempred  (Methylprednisolone 4 mg) –

  • Day 1 – 2 tablets after breakfast, 1 tablet after lunch, 1 tablet after dinner, 2 tablets at bedtime (total dose 24 mg/day).
  • Day 2 – 1 tablet after breakfast, 1 tablet after lunch, 1 tablet after dinner, 2 tablets at bedtime (total dose 20 mg/day).
  • Day 3 – 1 tablet after breakfast, 1 tablet after lunch, 1 tablet after dinner, 1 tablet at bedtime (total dose 16 mg/day).
  • Day 4 – 1 tablet after breakfast, 1 tablet after lunch, 1 tablet at bedtime (total dose 12 mg/day).
  • Day 5 – 1 tablet after breakfast, 1 tablet at bedtime (total dose 8 mg/day) .
  • Day 6 – 1 tablet after breakfast.

General advice:

  • Bed rest in the dark room
  • Avoid sudden movements or reading
  • Specific vestibular exercises from physiotherapist
  • Gradual resumption of activities
  • In case of dehydration due to excessive vomiting, hospitalise for intravenous fluids

Referral:

Consider referring the patient to ENT specialist if there is inadequate response to above therapies or if patient presents with additional complications. Patient will need surgical repair if there is evidence of perforated ear drum.