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Labyrinthine Concussion

What is a Labyrinthine Concussion?

A labyrinthine concussion is different from a brain concussion. A brain concussion affects how the brain works after a hit, fall, blast, or sudden jolt. A labyrinthine concussion affects the inner ear, which helps control hearing and balance.

Both can happen after a head injury, and the symptoms can overlap. A person may feel dizzy, off balance, foggy, or sensitive to motion. With labyrinthine concussion, symptoms are often more focused on the ear and balance system. This may include hearing loss, ringing in the ear, ear fullness, vertigo, dizziness, or trouble with balance.

A person can have a brain concussion, a labyrinthine concussion, or both. This is why it is important to tell your healthcare provider if dizziness, vertigo, hearing changes, or ringing in the ear started after a head injury.

What is Happening in My Body?

The force from the injury can disturb the delicate parts of the inner ear. This may affect how the hearing and balance systems send signals to the brain.

When these signals are not clear or even, you may feel dizzy, off balance, or sensitive to movement. You may also notice hearing changes, ringing in the ear, or ear fullness.

A head injury can also trigger other inner ear problems, such as: 

  • BPPV: Tiny crystals in the inner ear can move out of place. This can cause short bursts of spinning with changing head positions.
  • Vestibular hypofunction: One inner ear may become weaker than the other. This can cause dizziness, blurry vision with head movement, and balance problems.
  • Inner ear fluid irritation: The injury may affect the fluid system in the inner ear. This can sometimes cause ear pressure, dizziness, or vertigo that comes and goes.
  • Other inner ear problems: In some cases, a head injury may also lead to or uncover other problems, such as a small opening in the bone around the inner ear. Your provider may check for this if your symptoms fit.

Your provider may check for these because treatment depends on what part of the inner ear is affected.

Because of this, you may feel:

  • Dizziness
  • Vertigo
  • Unsteadiness
  • Lightheadedness
  • Tinnitus
  • Hearing loss
  • Ear fullness
  • Nausea

It is important to know:

  • Your symptoms are real.
  • This can happen after a head injury or blast injury.
  • It can affect hearing, balance, or both.
  • Many balance symptoms improve with time and the right care.
  • Hearing symptoms may improve, but sometimes they can last longer.
  • Vestibular therapy may help if dizziness or balance problems continue.

How is Labyrinthine Concussion Diagnosed?

A provider will ask about your injury and symptoms. They may check your ears, eyes, walking, balance, and hearing.

Testing may include:

  • Hearing test: This checks if the injury affected your hearing.
  • Balance testing: These tests check how well your inner ears and balance system are working.
  • CT scan: This may be used to look for a skull or inner ear bone fracture. It may also help check for other bone problems near the inner ear.
  • MRI: This is not needed for everyone, but it may be used if your provider needs a closer look at the inner ear, hearing nerve, or brain.

Not everyone needs every test. Testing depends on your symptoms and exam.

What Your Provider May Ask

At your appointment, your provider may ask you questions to learn more about your symptoms. Try to answer as best as you can. It may be helpful to think about, and even write down, your answers to the following questions before seeing your provider. 

Your provider may ask:

  • Did you have a recent head injury?
  • Were you near a blast or explosion?
  • When did the dizziness start?
  • Do you feel spinning, rocking, or lightheadedness?
  • Do certain head movements make it worse?
  • Do you have hearing loss?
  • Do you have ringing in your ear?
  • Do you feel pressure or fullness in your ear?
  • Do you have nausea or vomiting?
  • Do you have headaches, neck pain, or vision changes?

How is Labyrinthine Concussion Treated?

Treatment depends on what your provider finds. At first, you may need rest and activity changes. 

Your provider may recommend:

A trained clinician using the Epley maneuver to help move inner ear crystals back into place after BPPV from a labyrinthine concussion.

What Can I Expect Over Time?

Will I Get Better?
Many people improve, especially with the right diagnosis and treatment. Balance symptoms often improve more than hearing symptoms.

How Long Will It Take?
Some people feel better in days to weeks. Others need more time, especially if dizziness, hearing loss, headaches, neck pain, or concussion symptoms continue.

Can I Live a Normal Life?
Yes. Many people return to normal activities. Some people need vestibular therapy or follow-up care to help the brain and inner ear work together again.

When Should I Get Urgent Medical Care?

Seek urgent medical care right away if you have:

  • New weakness or numbness
  • Trouble walking
  • Trouble speaking
  • Double vision
  • A severe or worsening headache
  • Fainting or loss of consciousness
  • Chest pain
  • Repeated vomiting
    Seizure
  • Confusion or unusual behavior
  • New or sudden hearing loss
  • Clear fluid or blood draining from the ear or nose
  • A fall with a head injury

Questions to Ask Your Provider

It may be helpful to ask your provider the following questions to learn more about your symptoms and prepare for any future treatment.

You can ask:

  • Do you think I have a concussion or an inner ear injury?
  • Do I need a hearing test?
  • Do I need balance testing?
  • Do I need a CT scan or MRI?
  • Do I have BPPV?
  • Would vestibular therapy help me?
  • How long should I rest?
  • What activities should I avoid?
  • What symptoms should I watch for?

Key Points to Remember

  • Labyrinthine concussion is an inner ear injury after head injury or blast injury.
  • It can affect hearing, balance, or both.
  • It can cause dizziness, vertigo, ringing in the ear, hearing loss, and unsteadiness.
  • Testing may include a hearing test, balance tests, CT scan, or MRI.
  • Treatment depends on the cause of your symptoms.
  • Many people improve with time, guided activity, and sometimes vestibular therapy.

Additional Resources