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MagazineApril 2009 (Vol. 20 Issue 1)Labyrinthitis

The suffix '-itis' denotes inflammation; yet, in this case, it's seldom evident and is unproven (Moxham J, Souhami RL

The suffix '-itis' denotes inflammation; yet, in this case, it's seldom evident and is unproven (Moxham J, Souhami RL. Textbook of Medicine, 3rd edn. Edinburgh: Churchill Livingstone, 1997: 1075).

Labyrinthitis is often misdiagnosed as either 'benign paroxysmal positional vertigo' (BPPV) or 'M'eni`ere's syndrome', because of their similar, overlapping symptoms. However, in labyrinthitis, the onset of vertigo is abrupt, occasionally with nausea and vomiting, and can last for one to three days. The vertigo can be minimized by keeping the head still as it's provoked by head movement. BPPV is a syndrome characterized by short-lived episodes of vertigo triggered by rapid changes in head position. M'eni`ere's syndrome comprises sudden, recurrent attacks of vertigo, nausea, vomiting, nystagmus ('jittery' eyes), tinnitus (ringing in the ears) and slowly progressing deafness.

In my clinical experience, vertigo can be caused by malabsorption, usually due to a gastrointestinal dysfunc-tion such as hypochlorhydria (not enough stomach acid) or too little pancreatic juice. A fungal or parasitic infestation, or an imbalance in the usual gut flora can also lead to malabsorption and/or increased gut permeability.

An allergic response can cause a rupture of fluid in the labyrinth that can paralyze the vestibular nerves. High-resolution scans show narrowing of these passageways (possibly due to allergic swelling) in a significant number of patients with labyrinthitis (ORL J Otorhinlaryngol Relat Spec, 1986; 48: 282-6; Lancet, 1982; i; 655-7).

Other, often overlooked causes include organic illness (such as diabetes, hypothyroidism or hypoglycaemia), drug side-effects (such as methyldopa, phosphatidylcholine, procainamide or propranolol), alcoholism, 'caffeinism', sugar-dependence, so-called 'masked' food allergies, toxic environmental exposure (such as to the solvent dioxane) or withdrawal symptoms (such as from stopping smoking).

No orthodox medical treatment can be said to be fully effective for labyrinthitis. There are, however, a number of useful approaches to be found in natural medicine.


In cases where the vertigo (in an adult) is due to debris-so-called 'canaliths'-in the semicircular canal of the ear that continues to move after the head has stopped moving, the treatment of choice is the Epley manoeuvre. This comprises five specific osteopathic movements of the head and body that are designed to move the debris safely, and effectively, out of the ear canal and into a little sac (utricle) in the ear where it can no longer affect balance.


An abundance of evidence supports the role of allergies in labyrinthitis and M'eni`ere's syndrome (Otolaryngol Clin North Am, 1974; 7: 757; Laryngoscope, 1972; 82: 1703). Although conven-tional medicine mainly blames salt and advises a salt-free diet (Chatton MJ. Handbook of Medical Treatment. Los Altos, CA: Lange Medical Publications, 1972: 307), naturopathic medicine considers salt, gluten, caffeine, fried foods, alcohol and drugs to be possible culprits that should be removed from the diet (Trattler R. Better Health Through Natural Healing. Wellingborough: Thorsons Publishers, 1987: 432). Other naturopathic measures include supplementing with calcium, to improve the dietary calcium-to-phosphorus ratio, as well as vitamins B1, B2, B3, B6 and D3.


An extract of Ginkgo biloba leaves is helpful for all types of vertigo, tinnitus and acute cochlear deafness (Presse M'ed, 1986; 15: 1559-72). Dr John R. Christopher, the well-known American practitioner of botanical medicine and author of School of Natural Healing (Provo, Utah: BiWorld, 1976), recommends a few drops of garlic oil (say, the contents of a garlic capsule) instilled into the ears each evening at bedtime. The patient could also take two teaspoonfuls of cider vinegar in a glass of water, or use rosemary oil as an inhalant (Bartram T. Encyclopaedia of Herbal Medicine. London: Robinson Publishing, 1998: 291).

Treating children

When children have ear problems and vertigo, self-prescribed treatments are not recommended as there may be other, serious predisposing conditions. Here's how to recognize when your child's condition of the ear is serious.

Symptom When to worry

Pain in the earSevere, with fever

Discharge from the ear Long duration

Vertigo Severe

Deformity of the earSevere

Lumps around/on the earSevere, if with redness, painand deafness

Headaches Progressive, severe with

short history, with central

nervous system symptoms

Facial weakness With history of ear pain

DeafnessShort history, progressive

Tinnitus Progressive

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