Labyrinthitis is usually caused by viral infection. It may be a primary infection, the result of trauma, or a complication of influenza, otitis media, or meningitis. With chronic otitis media, cholesteatoma formation erodes the bone of the labyrinth, allowing bacteria to enter from the middle ear. Drug toxicity is another possible cause of labyrinthitis.

Because the inner ear controls hearing and balance, labyrinthitis typically produces severe vertigo (with any movement of the head) and sensorineural hearing loss. Vertigo begins gradually, but peaks within 48 hours, causing loss of balance and falling in the direction of the affected ear.