question-icon

Suggest treatment for labyrinthitis and sinus infection

default
Posted on Tue, 16 Dec 2014
Question: Hello,

I recently sought treatment from my GP and was diagnosed with labrynthitis secondary to a sinus infection or URI. My labrynthitis has presented symptoms of vertigo, hearing loss, tinnitus, nausea, and some moderate anxiety. The most striking of these symptoms was facial tingling which presents itself as an electric-type buzzing on only the left side of my face. Initially I was quite concerned but have since accepted that it is secondary to my labrynthtitis and since my symptoms have improved markedly. Unfortunately they have not fully resolved to this point. However, the left side of my tongue, has also presented numbness, but in a different fashion. Whereas my facial numbness presents itself most commonly during spats of vertigo/nausea/tinnitus, my tongue will also get numb upon eating food on the left side of my mouth. Upon looking at my tongue there is one point that appears to be inflamed and only when this point is touched does my tongue go numb. Likewise, when my tongue goes numb, it also radiates the numbness into my cheek and sinus. Most of my question is out of curiosity; however, is this a food allergy or some form of canker/cold sore? Likewise, could this numbness/tingling that originates in my tongue also be the cause of all my facial numbness? It is worth noting that my HSV-1 and herpes zoster manifests itself along my trigeminal nerve on my left forehead.

Thanks for your Time!
doctor
Answered by Dr. Sumit Bhatti (42 minutes later)
Brief Answer:
Labyrinthitis, Chorda Tympani, Trigeminal Nerve, Herpes

Detailed Answer:
Hi,

Thank you for your query.

1. Labyrinthitis includes vertigo, hearing loss, tinnitus, nausea and anxiety. I am assuming that the hearing loss has been confirmed by an Audiogram. If there is no hearing loss, it is a Vestibular Neuritis.

2. These conditions are usually viral in origin, but may be bacterial, following a head injury or stress related . There is a possibility of your symptoms worsening due to side effects of medication such as valcyclovir or gastritis due to medication.

3. Labyrinthine sedatives help in the short ter. These conditions are self limiting. Vestibular Rehabilitation Exercises (VRE) are important.

4. The Facial (Seventh Cranial) Nerve is very closely related to the labyrinth. The chorda tympani nerve is a branch of the Facial Nerve that supplies sensation to the anterior third of the tongue passes through the ear.

5. Sensation of the face is by the Trigeminal (Fifth Cranial) Nerve. The tingling will most likely be due to Herpes. Herpes zoster ooticus and opthalmicus is caused by reactivation of the chicken pox virus (which lies dormant in the body from childhood), usually under stress.

6. Both these conditions are fairly common and should respond to treatment.

If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (4 hours later)
Thank you for your response! However, perhaps I was not clear or I am misunderstanding you. I currently am not having an outbreak of either hsv-1 or herpes zoster. I have not had an outbreak since XXXXXXX My facial tingling started around the middle to end of october. Do you still believe this is a side effect of the herpes viruses even though I am not having an outbreak?
doctor
Answered by Dr. Sumit Bhatti (4 hours later)
Brief Answer:
Labyrinthitis /Post Herpetic Neuralgia / Malocclusion

Detailed Answer:
Hi,

Thank you for writing back.

1. Post Herpetic Neuralgia (pain and sensations) are unpredictable and may last for months to years. There is no known cure. however it may resolve slowly over the years and be controlled by treatment.

2. Hence it is not necessary to have an active Herpes infection. HSV-1 is a very widespread infection worldwide. This virus also can be dormant in the Trigeminal Nerve ganglion tends to cause cutaneous signs and symptoms.

3. Your current symptoms are most likely to be due to labyrinthitis, including the tongue numbness as explained earlier. However, due to the complex interconnections between the Cranial Nerves and sharing of autonomic nervous system fibers, the symptoms vary between person to person.

4. in your case there are two other possible causes besides Labyrinthitis for the tingling in the face:
a. Post Herpetic Neuralgia
b. The Trigeminal Nerve primarily supplies sensation to the face. In addition it also supplies motor nerves to the muscles of mastication. A class 3 occlusion wil cause stress and spasm of these muscles leading to possible sensory symptoms from this source.

5. I hope this answers your question.

If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2658 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for labyrinthitis and sinus infection

Brief Answer: Labyrinthitis, Chorda Tympani, Trigeminal Nerve, Herpes Detailed Answer: Hi, Thank you for your query. 1. Labyrinthitis includes vertigo, hearing loss, tinnitus, nausea and anxiety. I am assuming that the hearing loss has been confirmed by an Audiogram. If there is no hearing loss, it is a Vestibular Neuritis. 2. These conditions are usually viral in origin, but may be bacterial, following a head injury or stress related . There is a possibility of your symptoms worsening due to side effects of medication such as valcyclovir or gastritis due to medication. 3. Labyrinthine sedatives help in the short ter. These conditions are self limiting. Vestibular Rehabilitation Exercises (VRE) are important. 4. The Facial (Seventh Cranial) Nerve is very closely related to the labyrinth. The chorda tympani nerve is a branch of the Facial Nerve that supplies sensation to the anterior third of the tongue passes through the ear. 5. Sensation of the face is by the Trigeminal (Fifth Cranial) Nerve. The tingling will most likely be due to Herpes. Herpes zoster ooticus and opthalmicus is caused by reactivation of the chicken pox virus (which lies dormant in the body from childhood), usually under stress. 6. Both these conditions are fairly common and should respond to treatment. If you have any more questions I will be available to answer them. Regards.