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Neurology (Expert Forum)
i'm back -- no help, still dizzy
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i'm back -- no help, still dizzy
by LynnSB, Jan 21, 2003 12:00AM
I've written before.summary: i've been dizzy since April also had some swelling of the left side of my face, ear pain, burning, tearing,deep itching pain across my cheek. I had a root canal in June ( no abcess but a dead tooth); immediately afterwards, all pain disappeared ( but not the dizziness). by the end of the summer, I was experiencing room spinning vertigo episodes -- one lasted for hours and i went to the er. I would fall over if i bent my head backwards or forward. CT scan was normal; CT of sinus normal. MRI essentially normal. NO NYSTAGMUS was ever noted , even during horrible vertigo episode at er. I've had vestibular testing, normal.finally went to neurologist, says probably neuralgia but so atypical.. doesn't hurt to the touch. I'm sick allthe time. going to an endodontist for a second opinion on Thurs. Questions: how can i have vertigo ( worse with head movements) and have no nystagmus? could i have nerve involvement with vestibular system somehow that didn't show up in vesti. testing? i think my parotid gland onleft side is swollen, very subtle but i feel it. would a parotid tumor have shown up in ct scan, or mri? I am desperate. I feel dizzy, weird, almost constant ear pain, off balance, yet doc after doc says they can find nothing wrong.. although do see puffiness in face. does neuralgia cause swelling? any help? it is so hard to function like this..no one seems to care or take this seriously
Doctor's Answer
by CCF-Neuro-M.D.-JT, Jan 29, 2003 12:00AM
If this is a neuralgia, it is very atypical as that usually involves pain rather than swelling and vertigo. Unfortunately, despite the fact that dizziness is one of the most common complaints heard at a neurologist's office, no cause is ever found in up to 50% patients. Nystagmus does not have to always be present with vestibular dysfunction and there are many neurologic as well as non-neurologic causes for dizziness/vestibular dysfunction.
As for the anatomy questions, the facial nerve controls movement of the face rather than sensation (except for one branch to the ear) and the auriculotemporal nerve carries information regarding salivation and blood vessel dilation rather than vestibular and/or pain sense. A couple of diseases that do relate enlarged or abnormal parotid gland and dizziness include mumps infection and Sjogren's disease, a rheumatological disorder that can causes dry eyes and mouth as well as other systemic complaints. Technically, an abnormal parotid should have shown up on the MRI, but it's possible that this was missed especially if they weren't looking for anything there and the finding was subtle. If this is really disabling, consider a second opinion by a neurologist who specializes in vestibular disorders. Bring your films to be re-reviewed. Dr. Oas here at the clinic is board certified in bothe ENT and neurologist and has a dizzy clinic. Good luck.
As for the anatomy questions, the facial nerve controls movement of the face rather than sensation (except for one branch to the ear) and the auriculotemporal nerve carries information regarding salivation and blood vessel dilation rather than vestibular and/or pain sense. A couple of diseases that do relate enlarged or abnormal parotid gland and dizziness include mumps infection and Sjogren's disease, a rheumatological disorder that can causes dry eyes and mouth as well as other systemic complaints. Technically, an abnormal parotid should have shown up on the MRI, but it's possible that this was missed especially if they weren't looking for anything there and the finding was subtle. If this is really disabling, consider a second opinion by a neurologist who specializes in vestibular disorders. Bring your films to be re-reviewed. Dr. Oas here at the clinic is board certified in bothe ENT and neurologist and has a dizzy clinic. Good luck.
I woke up with such jaw/ear pain... and , of course, dizzy, but i guess there's nothing else left to be done. I can't help but try to find out what on earth to do next. thanks for any comments or suggestions.
The only thing that helps at all is very high dosages of ibuprofen ( 800 mg). which sure sounds to me like inflammation is involved. I had a low white blood count initially, then it went up to low normal. You'd think I'd have an elevated WBC if this were a bacterial infection. Mostly, I feel exactly how you describe it -- lightheaded, with spurts of vertigo sometimes.. just rotten. I don't understand how nothing, NOTHING canshow up on any tests. My dentist did find a "calcified pearl" thing sitting right above the root of the tooth that was dead ( the one i had the root canal in). He said it was not attached to the tooth and was sitting on the floor of my sinuses. The neurologist and ENT doc said it couldn't be doing anything. I also have pain on the side of my nose. This is not a little discomfor, it is wrecking my ability to work and care for my son. I don't want to do anything. Do head movements precipitate your dizziness at all?
Anyway, he fixed the bite by grinding down the tooth and crown beside it. But he doesn't think that is the explanation for my constant pain, ear pain