Question Title: Dizziness, spots of light

Forum: Neurology Forum
Topic: Multiple Sclerosis

I would like an opinion regarding some dizziness and visual changes (and other symptoms) I am experiencing. Many of these symptoms are probably unrelated but I'll describe them chronologically just in case.

About 2 years ago I started having numbness and tingling in my left hand. After 2 chiropractic adjustments to my upper back, the numbness went away for about six months.

About 1 year ago, for a period of 3 weeks, I had a constant, mild, lightheaded/dizzy feeling which I ignored. Some weeks later, I woke up one morning with a roaring noise in one ear. It grew over several hours to the level of normal conversation and then decreased to the level of a loud whisper
over the next few hours. It gradually disappeared over the next 4 days. I ignored this also.

Also about 1 year ago, I found that I could not sleep in a prone or semi-prone position without the front or sides of my thighs going to sleep. A new mattress did not solve this, but an extra thick down pad has helped. About this time, I noticed a palm-sized spot on the left side of my thigh which is permanently numb. I can feel pain, temperature, etc. there, but they are significantly reduced.

In August of last year I had an attack of shingles affecting my neck and right shoulder.

In September, I began frequently feeling short of breath while reading aloud to my son and I sometimes woke up gasping for air. I did go to a doctor but shortly afterwards caught a bad flu which lasted nearly six weeks. When, after the flu had cleared and I was still SOB, I had a series of lab tests which were normal except for one slightly low ACTH level and slightly low blood pressure. He
suspected perhaps something like Addison's but follow-up lab tests for ACTH levels did not support this. He suggested stress.

In November I began to have palpitations, headaches, nausea, and significant fatigue. I was having difficulty concentrating and found myself constantly searching for words in conversation. I also found myself shaky after moderate or heavy exertion.

In early December, the dizziness returned with a vengeance. I began having episodes lasting from 20 seconds to 10 minutes, with 10 to 40 or more episodes/day. The sensation was something between dizziness, vertigo, and the feeling one gets when exposed to laquer thinner fumes too long (not a habit of mine, but I used to do a fair bit of woodwork, honest) but not exactly like any of them. I began calling it dizziness because that was the closest. It does not affect my balance, co-ordination, cause nausea, headache nor give me the feeling that the room is spinning. I noticed that it strongly correlated with body temperature. I observed that my body temperature would cycle 6 or 8 times/day
between 96.9 and 98.9 and the higher the temperature, the stronger the sensation. Fully 90% of the episodes would occur when my temperature was over 97.9. It increased over a couple of weeks and at its worst, the sensation was nearly overwhelming, far beyond what I could produce by spinning in my chair for several minutes. Movement or changing the position of my head did not cause or affect this sensation.

In late December, when the dizziness had reached its peak, I began having the same dizziness associated with visual stimuli. These attacks would last only seconds and usually occur at the exact same spots while walking along the hallways where I work. I think they are triggered by variations in lighting but wonder if somehow the patterns of lines (doorways, tiles, etc.) could be involved. Walking with my head down, looking at the floor will trigger the dizziness more than half the time.

In January, the palpitations, nausea, fatigue, shakiness and concentration problems faded, my energy levels returned to normal and except for the dizziness and SOB I felt great. I then began having constant heartburn and my own research suggested Acid Reflux could be the cause of the SOB. I began taking Tums and Maalox and within 2 weeks had the SOB mostly under control.

In late January, I began to notice bright spots moving like fireflies in my peripheral vision. This usually occurred after bending down or exerting myself, but not always. It happens about once every couple of days and the spots last only a few seconds. I also began seeing "sparkles", bright non-moving dots
in my peripheral vision when looking at objects in bright light. The first occurrence was when I was filling my tank and reading the gas pump. I could suddenly see hundreds of sparkling specks against the cloudy sky in the background. This has progressed from occurring only in bright sunlight to normal
roomlight. The sparkles usually only show against a bright background (a wall, cloudy sky, a piece of paper, etc.) and last as long as I look at that object. The "sparkles" are not episodic. If the light is bright enough, I can reproduce this at any time by looking at an object for as little as one second. The
longer I look at the object, the more sparkles appear. If I shift my gaze, they will disappear. Thinking that maybe the excess calcium was involved I stopped the Tums, the SOB returned, I switched to Zantac but both symptoms persist. I have also had occasional pain at the back of my eyes when moving them to the extremes.

In early February, the episodic dizziness had faded away. Shortly before it faded, I began to suspect a correlation with fluid intake but was unable to confirm this. It seemed that the more I drank the stronger the sensation would be. The visually triggered dizziness had grown stronger, could now be
triggered more easily, and lasts as long as the visual stimulus does. There are days when "If I am moving, I am dizzy". I have discovered that the dizziness can be greatly reduced or eliminated if I cover one eye while walking. The sparkles can also be reduced by covering one eye. I described this to my doctor and he says this is not a neurological problem. I went to an optometrist who also found no problems.

The numbness/tingling in my left hand has been almost constant over the past six months. The muscles in my neck seem to be involved somehow. They have been knotted up, stiff and sore for the last six weeks, although right now after three chiropractic adjustments in the last 2 weeks, my neck muscles feel fairly normal and the tingling is very slight. The numb spot on my leg has not responded to chiropractic treatment.

My doctor says he does not know what is the cause, but he hopes it will get better on its own. He says he does not think it is MS. He has recommended no treatment or further testing. Now what?

I must apologize for the length of this, but I am unconvinced that this will resolve itself in time. The dizziness seems to have reached a plateau, the sparkles seem to be increasing (moving closer to the center of my vision) and I still have occasional headaches. I am a 34 year old male, non-smoker, non-
drinker and I exercise regularly.

I would appreciate any comments you can offer.

Dear John:

Wow, alot of horrible symptoms. Although it is difficult to say, I don't have the benefit of a good neurological exam, you may be experiencing an inner ear problem. This may be due to many reasons but your symptoms have that sort of flavor. I would see a neurologist who is an expert at inner ear problems. At least this will give you a start on trying to find out what the problem might be. Good luck.

Sincerely,

CCF Neuro[P] MD

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