II. Epidemiology

  1. Incidence: Rare

III. Etiology

  1. Complication of Acute or Chronic Otitis Media
  2. May be associated with Cholesteatoma

IV. Symptoms

  1. Sudden onset Vertigo with severe Nausea and Vomiting
    1. Symptoms persist in first 12 hours despite immobility
  2. Complete Hearing Loss in affected ear
    1. Distinguishes Labyrinthitis from Vestibular Neuronitis
  3. Associated with Tinnitus

V. Signs

  1. Rapid Nystagmus toward opposite side

VI. Course

  1. Vertigo and Nystagmus resolve over days to weeks
  2. Tinnitus resolves
  3. Hearing Loss persists

VII. Imaging: CT Head or MRI Head

  1. Assess for Brain Abscess

VIII. Management

  1. Antibiotics for 10 day course

IX. Complications

  1. Persistent Hearing Loss in the affected ear is the norm
  2. Meningitis from local spread

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