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Labyrinthitis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Inflammatory disorder of the inner ear

  • Inflammation decreases afferent firing from the labyrinth

    • CNS interprets the decreased signal as head rotation away from the diseased labyrinth

    • Th...

Diagnosis

Signs and Symptoms

History

  • Vertigo:

    • Peripheral vertigo

    • Sudden onset

    • Associated with movement, head position

    • Sensation of room spinning or off balance

  • Nausea and vomiting

  • Episodes of hearing impairme...

Treatment

Pre-Hospital

  • Cardiac monitor for arrhythmia

  • Finger-stick glucose to exclude hypoglycemia

  • Acute stroke assessment

  • Antiemetics for nausea and vomiting

  • IV fluids for dehydration

  • Fall precautions

Initial Stabilization/Therapy

Follow-Up

Disposition

Admission Criteria

  • Symptoms concerning for an acute stroke or central etiology of vertigo

  • Intractable nausea and vomiting

  • Severe dehydration

  • Unsteady gait

Discharge Criteria

  • Tolerate or...

Pearls and Pitfalls

  • Counsel patients regarding occupation, fall risk, and driving

  • Failure to diagnose life-threatening conditions like meningitis, cerebrovascular ischemia, or brain tumors

  • Take caution ...

Additional Reading

Codes

ICD9

  • 386.30 Labyrinthitis, unspecified

  • 386.31 Serous labyrinthitis

  • 386.35 Viral labyrinthitis

  • 386.33 Suppurative labyrinthitis

  • 386.34 Toxic labyrinthitis

ICD10

  • H83.01 Labyrinthitis, right ear

  • H83.02 Lab...

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