From: anonymous@aol.com
Subject: 9 months of unsteadiness
Posted-By: xx108 (ENT Clinic Moderator)
Organization: Organization For Community Networks
Date: Sat, 10 May 1997 00:54:54 -0400 (EDT)
Newsgroups: ofcn.clinic.ent

I am 29 years old and have been suffering with episodes of feelings of "unsteadiness" lasting usually 5-7 days then it imporves and goes away. I started with complaints of dizziness 9 months ago which was diagnosed as an ear infection and treated with antibiotics for which I later improved.
Almost 2 months later, I started to have allergy symptoms followed by dizziness - I saw my primary who did a tympanogram which was flat on one side. I took Zephrex and Antivert and improved back to normal. Now it seems that any bout of cold or allergy symptoms is followed by a few days of feeling "unsteady", fullness or pressure in the right ear with popping. It seems each episode has gotten less severe (unless my body has just become accustomed to this). I have had and EKG, Stress test, holter monitor and labs (CBC, chemistry, TFT's) drawn all of which were normal. I have seen an ENT who did an ENG which I was told was "normal". I have also seen a neurologist and had and MRI done which was essentially normal except for one punctate bright spot (not enhanced) in the left frontal part of the brain.
The neurologist was not concerned about this. The final diagnosis has been vestibular neuronitis. My concern is if this is what I have should the ENG have showed some abnormality even if I was not symptomatic when it was done??
What would you recommend as the next step in diagnosis or should I just accept this and expect it to continue each time I have a viral cold or illness? I am currently being treated for sinusitis with Amoxicillin and have started with my symptoms of unseadiness again after one severe attack of vertigo while driving this week. Any advice or information would be appreciated.

Reply: --------------------------

It sounds as though you have had an extensive workup for your dizziness. As you have suggested, I think it would be unlikely to have vestibular neuronitis with a normal ENG. More likely you simply have a sensitive inner ear which becomes disturbed with allergy or upper respiratory conditions that affect the ear or sinus. Therefore, treatment of acute allergy or upper respiratory infections may be all that can be offered.

--

Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

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