Which investigations should be considered in a patient with suspected labyrinthitis to rule out other causes of vertigo?

In a patient with suspected labyrinthitis, initial investigations should focus on excluding other causes of vertigo through a detailed clinical assessment supported by targeted investigations. Basic blood tests including full blood count, inflammatory markers, and glucose levels may be considered to exclude systemic causes ¹. Hearing assessment1,⁴. Vestibular function tests, such as the head impulse test, can help assess vestibular nerve function and support the diagnosis ¹.

Neuroimaging, particularly MRI of the brain and internal auditory meatus, should be considered if there are atypical features, focal neurological signs, or if central causes of vertigo need exclusion, such as stroke or multiple sclerosis ¹,³. This aligns with current diagnostic procedures emphasizing MRI to rule out central causes in vertigo presentations (Walther, 2017). Electronystagmography or videonystagmography

In summary, investigations to exclude other causes of vertigo in suspected labyrinthitis include blood tests, audiometry, vestibular function tests, and neuroimaging when indicated by clinical features ¹,³,⁴; recent literature supports the use of MRI as a key tool to exclude central causes (Walther, 2017).