Dear Doctor,
I am a 42 year old Indian male and came across your Web site while
browsing through related topics on the Net. I would be highly obliged if
you would throw some light on a dizzyness problem which has been
nagging me for over 3 years now!
The problem started all of a sudden during mid-June 1994 when I was
in Vienna towards the end of a 3-month training course. While standing
and talking with a few friends, their faces suddenly seemed to waver. Over
the next few days the dizzyness, unsteady feeling while walking, nausea
and general malaise increased rapidly. Incidentally, for about 2 months prior
to this, I suffered from a persistant throat infection which was not treated.
Back at Calcutta, I was referred to a number of specialists who diagnosed
my problem as "Vestibular Neuronitis" - and all opined that the disease was
self-curing and would go away in a few weeks. Various tests were conducted -
MRI scan of the brain, X-Rays of the neck and spine, a battery of blood tests
etc. - all were apparently normal. I was also referred to Neurologists and Eye
Specialists but no abnormalities were detected.
The intensity of the problem did indeed go down over the months - not
weeks - but has never gone fully except for a rare day or two in between. Over
the years, the "pattern" of symptoms have also changed. During the first year
it was mainly an "intoxicated feeling" while standing or walking, feeling of
nausea and uneasiness on the left side of the head, I could not bear to walk
in crowds as people passing by would make my head reel... During the second
year, symptoms subsided but never vanished. For about three months another
peculiar symptom surfaced - an almost daily frontal headache mainly in the
evenings.
Repeat visits to Doctors have not helped - some have even told me that it is
"functional" - not real! One Doctor also felt that it could be "post-viral
syndrome" which could last for years.
At present, the nagging symptoms are:
1. A continuous uneasy (though mild) "swaying" feeling on the left side of
the head. Something in between dizzyness and swaying. Objects don't "rotate"
but the "feeling" is as if things were not steady.
2. Much better while lying down or even sitting - worse on standing or
walking.
3. Feeling of "unequal vision" between left and right eyes. Sometimes
a "blocked" feeling in the left ear. Also, sometimes a thread-like throbbing
pain along left side of the head, front to back.
4. Increases with physical and mental strain, decreases with rest.
I don't want to sound hypochondriac but this continuous left-sided
dizzyness for over 3 years now is really affecting my work and day to day life.
Undoubtedly, the severity is much less than what it was 3 years ago - and on
those rare days when symptoms disappear - I feel simply elated! Unfortunately,
the problem usually recurs and stays from the very next day.
I would be very grateful if you would kindly give me your valuable opinion.
Can "Vestbular Neuronitis" really take over 3 years to heal? Is it something
I have to accept and live with? Or are there any tests or possibilities
which may have been over-looked? Please help!
Reply: ----------------------------------
Unfortunately, even despite extensive, high-technology evaluations, it is not always possible to determine the cause or provide a specific diagnosis for some cases of dysequilibrium. It is important to understand that the inner ear is but one possible location for a disturbance that could result in dysequilibrium. Circulatory problems, central nervous system problems, vision problems, spinal disorders, metabolic disorders such as diabetes, hormonal abnormalities such as thyroid disease, are just a few of the possible causes of dysequilibrium. It is possible that an acute process such as acute vestibular neuronitis or labyrinthitis could result in a chronic vestibulopathy or inner ear disturbance. It should be possible to determine the presence of vestibular dysfunction by neurotologic testing such as electronystagmogram (ENG) or dynamic platform posturography. However, even if a vestibular dysfunction could be detected, it may be that all that could be provided would be symptomatic measures rather than curative treatment. You might consider an evaluation by an otolaryngologist who limits his/her practice to neurotology.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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