I am almost 30 yrs. old. On and off, I've had bouts of vertigo. Usually, this would cause spinning, but seemed based on the position of the head. I remember getting this as young as 5 (though nothing was ever done for, i.e. going to the doctor). It would be problematic the first few days, but mostly subside. However, it would usually take up to a month or so before it finally cleared and I no longer had symptoms.
Three years ago, I decided to get some medical attention. The doctor (at a campus health center) thought it might have been benign positional vertigo, and this seemed to fit in with what I had been experiencing, i.e., spinning of the room, lasting for periods of 30 seconds or so. It was suggested I do exercises to induce the dizziness in order to "fatigue" it. Two to three days later, I felt a lot better, and thought it had gone away completely.
About five months later, it recurred again. This time I went to a primary care physician, who looked and noticed that I had "allergy like symptoms", post nasal drip, congestion, cough. Now, I've always had some stuffiness of the nose, sometimes the nasal discharge (or whatever it's called) would be greenish white in color. He gave me Entex and amoxycillin (a decongestant and some penicillin like substitute) and wanted me to use beconase (a steroid decongestant which is taken through the nose). This certainly helped me breathe better, and the decongestant seemed to cause the balance to fix up very quickly.
Ever since then, I haven't gotten the full dizziness, but much more frequently, I getting motion in my vision, typically due to motions. For example, jumping up and down, walking down the stairs would cause a "bump" in my vision. To give you an idea of what that's like, it's as if you were shaking your head up and down quickly, except I'm not shaking my head up and down. However, that's what I see and feel. This comes and goes. Sometimes it stays around for a day, sometimes a week, and then usually goes away for a few days. Nothing too bad, but still annoying. The "vertigo" therefore has changed and is no longer associated with what position my head is in, but just due to motion, and it is just motion that seems to cause it.
I usually notice it happening when I wake up. For example, if I wake up, and there's none of this sensation when I walk, then it's usually fine for the whole day. I recently discovered that if I took a nap sleeping on my side, this seemed to fix it up. So, if there was excessive motion, then sleeping on my side for half an hour seemed to help, i.e., I would no longer get the sensations of imbalance when walking.
Recently, I again went to a campus health center, and they gave me Allegra (an antihistamine) as well as told me to get a saline spray (to clean the nasal passages) as well as use Nasalcrom (an over the counter anti-allergy drug, taken nasally). For two or three days afterwards, I felt better, with no balance problems. Then, it came back again. The second day after it came back, I felt quite a bit worse, and went back to the health center, where they noticed fluid build up in the middle (?) ear (there was no pain, however). They told me to add a decongestant (Sudafed) to what I was taking. This cleared up my balance problems in about an hour, and I took it for the next few days, feeling basically a lot better.
Let me quickly run over other symptoms that might prove useful. I tend to be somewhat congested most of the times. I can breathe through my nose, but with effort. At time, this causes the nasal stuff to be green. Usually, if I sleep and it is cold, I will wake up with a runny nose and be a little congested. When I was young this happened a lot, though it got better through the day. I also grind my teeth (bruxism) and tend to be feel soreness in my legs (restless legs syndrome?) which is not due to exercise. This causes me to move around a lot during sleeping, although I usually fall asleep and don't have real sleep problems.
I do tend to drink a lot of coffee and sugar, but this doesn't seem to make the problem more aggravated, as far as I can tell. I know getting off of coffee is something like a withdrawal off addiction, and can causes sluggishness, runny noses, and headaches.
So, given all that, what would you say the problem is? Why did taking decongestants help? Will it always continue to help, or is there some better long term treatment? For most of last year, I felt pretty good. I had, oddly enough, thought that my taking of acetominophen (Tylenol) was helping though it might have been a placebo. I was coming back from vacation, had a headache, then took Tylenol. Then, my balance seemed OK the following day. Now, I also find sleeping on my side helps too. I had been sleeping on my back for a while, and felt a buzzing sensation in my body, and this was uncomfortable, but sleeping on my side (which is the way I had always slept before the last serious bout of vertigo) helps.
Any thoughts or suggestions would be useful. Thanks.
Reply: ----------------------------
It is possible that you may have a chronic vestibulopathy or inner ear disturbance that can be exacerbated by a number of different stimuli including motion, upper respiratory infections, and/or allergies. If you are interested in pursuing a specific diagnosis, I would recommend further evaluation by an otolaryngologist - perhaps one that limits his/her practice to neurotology. However, it is important to understand that while a specialist might conclude that there is indeed an inner ear disturbance based upon physical examination and neurotologic testing, not all symptom complexes will fit nicely into a textbook diagnosis. Furthermore, there may be little that can be done to cure the problem and treatment may be limited to symptomatic therapy (treating the symptoms).
--
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.
Click here to review
previous Ear, Nose and Throat Clinic consultations