How can I effectively counsel patients on the expected recovery timeline and potential complications associated with labyrinthitis?

Recovery Timeline: Reassure patients that symptoms of labyrinthitis (vestibular neuronitis) typically settle over several weeks, even without treatment. Acute severe symptoms usually resolve within a few days, but milder unsteadiness and imbalance may persist for weeks. Patients should be informed that recovery can be fluctuant, with possible periods of symptom worsening during the recovery phase.

Activity and Rest: Advise that bed rest may be necessary during the acute severe phase but encourage resuming activity as soon as possible to promote vestibular compensation, which aids recovery.

Safety Precautions: Counsel patients not to drive while dizzy or if they might experience sudden vertigo, in line with DVLA guidance. They should also be advised about workplace safety if their vertigo poses risks, and about fall prevention measures at home during episodes of vertigo.

Potential Complications and When to Seek Further Help: Inform patients to return if symptoms deteriorate or do not improve after one week, as persistent symptoms may require referral to a balance specialist for further assessment or vestibular rehabilitation. Severe nausea and vomiting that prevent oral intake warrant hospital admission for intravenous treatment. Persistent symptoms beyond six weeks may require further investigation or rehabilitation.