What are the key clinical features that differentiate labyrinthitis fr

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Key clinical features differentiating labyrinthitis from vestibular neuronitis in primary care:

Vestibular neuronitis typically presents with sudden onset of severe vertigo, nausea, vomiting, and gait unsteadiness without hearing loss or tinnitus. The vertigo usually lasts days, with gradual improvement over a week, although mild imbalance may persist for weeks. There are no auditory symptoms because the cochlear nerve is not involved ,.
Labyrinthitis presents similarly with acute vertigo, nausea, and vomiting but is distinguished by the presence of hearing loss and/or tinnitus due to involvement of both the vestibular and cochlear components of the labyrinth ,.
In labyrinthitis, hearing loss is a key differentiating feature and should prompt consideration of referral to ENT or audiovestibular services for further assessment .
Both conditions may require symptomatic treatment and referral if symptoms persist beyond one week or if severe nausea and vomiting prevent oral intake ,.

What are the key clinical features that differentiate labyrinthitis from vestibular neuronitis in a primary care setting?