Labyrinthitis

BSC NURSING II YEAR

1. LABYRINTHITIS Mr. Manikandan.T , RN., RM., M.Sc (N)., D.C.A .,( Ph.D ) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry .

2. DEFINITION Inflammation of ear the inner ear or the nerves that connect inner ear to the brain

3. CAUSES /RISK FACTORS Upper respiratory infection – common cold, flu Virus bacteria Middle ear infection Meningitis Head injury Smoking Alcohol Stress Allergy

4. CLINICAL FEATURES Dizziness N/V Hearing loss Vertigo Tinnitus Loss of balance ( Nytagmus ) Hearing problem

5. DIAGNOSIS H.C P/E CT MRI EEG Electronystagmography (eye movement) Audiometry

6. MANAGEMENT IV - Antibiotics Vomiting – ondensatron - ante emetics Vertigo – Tab. Cinnerazine (Calcium channel blocker) Anxiety - benzodiazepines Depression – SSRI ( Citalopram , fluoxetine ) Allergy – diphenhydramine (anti histamine) Antiviral Fluid replacement

7. vestibular rehabilitation therapy Cawthrone – cooksey exercise In bed or sitting Eye movements -- at first slow, then quick up and down from side to side focusing on finger moving from 3 feet to 1 foot away from face Head movements at first slow, then quick, later with eyes closed bending forward and backward turning from side to side. Sitting Eye movements and head movements as above Shoulder shrugging and circling Bending forward and picking up objects from the ground

8. Standing Eye, head and shoulder movements as before Changing from sitting to standing position with eyes open and shut Throwing a small ball from hand to hand (above eye level) Throwing a ball from hand to hand under knee Changing from sitting to standing and turning around in between Moving about (in class) Circle around center person who will throw a large ball and to whom it will be returned Walk across room with eyes open and then closed Walk up and down slope with eyes open and then closed Walk up and down steps with eyes open and then closed Any game involving stooping and stretching and aiming such as bowling and basketball

9. GAZE STABILIZATION Seated on a chair Focus on a small target or your thumb at eye level in front Look at the target, turn your head to the left and continue to look at the target Now turn your head to the right while still focusing on the same target Repeat turning your heard left and right for 1 minute

10. CONT., Seated on a chair Raise two small targets or thumbs to eye level and move them slightly apart Focus on the target on your left with your eyes, then turn your head towards the same target Then focus on the target on your right with your eyes, then turn your head towards the same target Repeat the same steps for 1 minute

11. CANALITH REPOSITIONING EXERCISE Step 1.  First you move from a sitting to a reclining position with your head turned to the affected side by 45 degrees. Your health provider will help extend your head over the edge of the table at a slight angle. Step 2.  With your head still extended over the edge of the table, you'll be prompted to turn your head slowly away from the affected side by about 90 degrees. Step 3.  Roll onto your side. Your head should be slightly angled while you look down at the floor. Step 4.  Finally, you return carefully to a sitting position with your head tilted down and returned to the center position.

12. brandt-daroff exercises Start in an upright, seated position. Move into the lying position on one side with your nose pointed up at about a 45-degree angle. Remain in this position for about 30 seconds (or until the vertigo subsides, whichever is longer). Then move back to the seated position. Repeat on the other side.