Question Title: Dizzy for 6 months

In the middle of the night on October 13, 1997 my 62 year old mother turned to look at the clock and everything began to spin. Six months later and it is still spinning. The next morning the dizziness continued, and in addition the family noticed a drooping of the right eyebrow, lid and mouth. This did improve over many week's time. She also exhibits very slowed speech, a shortness of breath, and confusion. The family thought that she had had a stroke. She is now depressed. She has little, if any balance; she falls several times a day. She is now on 50 mg of antivert given 3 times a day and 100 mg of Zoloft. She has bouts of nausea. She complains of a pain in the left side of her neck and that both of her arms ache. She experiences hot flashes so strongly that her hair will be wet.

She has been to so many doctors and had so many tests and repeats of tests. There is no answer as to why she is still so dizzy. Nothing seems to improve her symptoms. What could this be that all the specialtists (cardiologist, neurologist, ent, pulmonary, etc. just to name a few) are missing. It is like something has increased the nerve sensitivity to balance but there is nothing. MRI's, CAT scans, blood tests, repeated blood tests. She is on the verge of giving up hope. Please give us a new or better direction to search in. Before this began, my mother was a vibrant, energetic woman that loved to travel, go dancing on Saturaday night, and grow flowers that were the envy of "Better Homes and Gardens." Help us , please.

Dear Joyce Ann,

I am not going to be able to come up with a "diagnoses" on your mother without doing a neuro exam, reviewing the history and prior work up. The differential diagnosis of vertigo is long. However, from what you have told me it sound as if your mother had an acute onset of vertigo as well as other brainstem abnormalities. The combination of these symptoms points to a "central" lesion rather than a "peripheral" lesion. The differential would include stroke (brainstem or cerebellum-that would be seen on mri and possible CT, epecially if performed greater than 12 hours after the symptoms onset), tumors (probably ruled out by contrast mri studies),multiple sclerosis (prob. seen on MRI, unlikely), seizures ( do to the continuous nature of you mom symptoms, unlikely). Another more likely possibilty would be a viral encephalitis (which is a viral infection of the brain that can cause vertigo and focal neurological symptoms). Onset usually follows a viral infection with symptoms ( as above) developing acutely. A spinal tap, may give some data. The encephalitis is usually benign and self-limited. Recovery in reported cases ranged from a few days to several months. It sounds as if your mother is improving in some ways facial droop, etc. Chronic central vertigo may repsond the the "vestibular sedatives" such as antivert (part of the anticholinergic class of drugs). Occasionaly adding a medication from the antidopaminergic class, such as, prochloroperazine will bring more relief than a single medication. Talk to your doctor regarding these options. If you are interested in getting an evaluation at CCF, call 1-800-CCF-CARE. Good Luck.

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