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921053 tn?1245180795

caloric weakness??? what is this????

Hi everyone...I have posted prior questions about the vertigo issues and the vestibular rehabilitation.  I am happy to say that the vertigo has let up some and I am not tripping over my feet anymore :)  I think this is probably because I am determined to live as normally as I possibly can and push myself everyday to do the "normal" things I have always done.  I started my vestibular rehab this morning and really like my PT therapist.  She got all my records and did her own research on Chiari :)  Even though the neurotologist ordered neck exercises, she said she wasn't messing with my neck cause she feels like it would cause more damage!!!  Anyway, she disclosed the at the VNG test showed a 27 % caloric weakness in my right side of the vestibular system...which would make sense for the dizziness.  What exactly does this mean...I haven't been able to find anything online that explains this to me?????  I am wondering if all of this is related to the fact that I had menengicocal (sp) meningitis as a young infant.  

Also, I am still waiting for the stupid neurosurgeon to schedule the MRI of my spine and to get a Cine MRI...wish they would just schedule it and get it over with so that I can know exactly what my situation is!!!!
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620923 tn?1452915648
COMMUNITY LEADER

  Have u had ne other testing then the VGN?

Ne MRI's?....cervical spine, thoracic, lumbar, or brain?.......

U may also want to look into ur vitamin and mineral levels,...many times low levels can cause dizziness...Vt D, B12, and magnesium and Potassium.

With the MRI's u can rule out ne disk issues that may be compressing on ur nerves....
Helpful - 0
Avatar universal
Thanks for the post!  I don't have a Chiari DX, not really any diagnosis yet, just beginning the process of trying to figure out what is causing the dizziness.  I stumbled on the site trying to figure out the caloric weakness measurements.  Any info would be helpful!
Helpful - 0
620923 tn?1452915648
COMMUNITY LEADER

  Hi and welcome to the Chiari forum.

Do u have a Chiari DX too? Most here were trying to see the relationship btwn the caloric weakness and chiari....so I wondered if u too had this condition?

Not sure I could offer ne insight to the CW as I did not have testing for it....VGN that is...so, other then the other comments I already made to the  thread I do not know how else to offer help...except to say someone else may post that has a bit more info.

Good luck
Helpful - 0
Avatar universal
I recently had a VNG done, and results came back listed as Normal, but with an 18% caloric weakness in my left ear, and a directional preponderance of 13% to the left.  The Dr. did not address any results specifically, just saying they were normal, and really offered no further course of action to diagnose my dizziness (30 second or so episodes followed by intense ear ringning, worse on left ear), aside from labs which I feel he only requested because I brought potential issues up in my family history, and prior issues during pregnancy.  I noticed these notes on the VNG report they gave me after my appointment was over.  Are these % actually "normal" and what potential problems do they indicate?  Did anyone else have INTENSE pain with the warm air portion of the VNG?  I mentioned it during the test, and to the Dr. at the follow up appt. and both said it might just be the position of the tip.  Really?  It just doesn't seem "normal" to me.
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Avatar universal
Nothing is actually wrong with your eyes if you have abnormal calorics. It could potentially be an issue with the eyes but in your case it doesnt sound like it. Your eyes and balance system are closely related. Its called the Vestibulo-ocular reflex (VOR). We test your VOR in many different ways, one of them is your calorics. An abnormal vestibular system (peripheral or central site of lesion) causes an abnormal response from your eyes because the two systems work together.

-1st year audiology student
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620923 tn?1452915648
COMMUNITY LEADER

  I know my vertigo was a neuro issue as well, and nothing to do with the crystals in my ear canal, but my Drs still had me utilize the  technique when getting out of bed etc...not sure y, but I am sure it was the slowing down that may have helped???

Good luck in getting ur results, please post what u find out.
Helpful - 0
Avatar universal
Epley maneuver does not work on vestibular neuronitus, not on meds anymore and finished with PT which helped some.  I'm now waiting for an appointment with an ENT Dr from the VA as a follow up to the testing I had done.
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620923 tn?1452915648
COMMUNITY LEADER

  Well all of us here on this forum do, and we do deal with vertigo along with it....
  Have they had u try the Epley maneuver to see if that would help ur vertigo? I have a friend and her dad has issues with vertigo, but I do not think he also has the nystagmus with his eyes.....

May I ask what meds or treatment they have tried?
Helpful - 0
Avatar universal
Because I acquired a severe case of vertigo which the Dr at a hospital said was benign positional vertigo but had a vng and a eng by the VA and was diagnosed with vestibular neuronitus and so the hospital misdiagnosed my condition.  I do not have chiari malformation
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620923 tn?1452915648
COMMUNITY LEADER

  Hi and welcome to the Chiari forum.

Do u also have a dx of Chiari Malformation or Syringomyelia?

So u have an issue with ur eyes with rapid involuntary movement and  an issue with ur ears?

It would help if u explained y u had the testing....we r not medical professionals, but try to share related experiences when possible ,

Helpful - 0
Avatar universal
If there is anyone that can answer this diagnosis it would be greatly appreciated
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Avatar universal
My audiology Dr said that I have a 100% caloric weakness and a slow velocity left beating nystagmus to ice water caloric in the right ear. The audio gram is unremarkable revealing a long h/o symmetrical sensorineural loss.  This is all Chinese to me, what does it all mean?
Helpful - 0
555358 tn?1292532061
Have a great time!
Helpful - 0
921053 tn?1245180795
I am scheduled to see a pediatric specialist at MCV (medical college of Virginia) on 6/18...hopefullyhe will have some answers for me and at least conduct the MRI's that I feel are necessary...will keep you up to date

Gotta get away from all of this so I am going to the Outer Banks of North Carolina until I have PT again next Tuesday...I have a friend with a beach house and they want me to come and "leave my worries" here in VA....vacation much overdue!!!!!
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620923 tn?1452915648
COMMUNITY LEADER
....I know what u r feeling I always said I felt like a ping pong ball......

I would gather that neither the NL ot NS are Chiari specialists and that is y this is happening.....find a specialist.....and feel like a human again. : )

"selma"
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921053 tn?1245180795
I have been seeing a neurotologist and he sent me to the neurosurgeon and keeps telling me that it is a "neck" issue and not vestibular????  The neurosurgeon says it is vestibular???  I feel like I am being passed along like a hot potatoe!!!
Helpful - 0
555358 tn?1292532061
Beachlover, you need to see an otologist/neurotologist - a balance specialist. Your Chiari Neurologist can get you a referal.
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Avatar universal
I'm jumping in late as well. I had the eng and my right ear had a weakness in it as well. I didn't get dizzy at all when the water was put in. I did a couple of appt with the pt for vestibulat but then found out my ins wouldn't cover it so I didn't go back.

I was complaining of blurry vision in one eye so my neuro sent me to a neuro opthomologist. They ran a bunch of test and couldn't find anything wrong with my eyes.

Ear problems can make you dizzy and off balance. I think the vestibular therapy will help you but I would ask the dr. to send you to the neuro op to have your eyes checked as well.

Dawn
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620923 tn?1452915648
COMMUNITY LEADER
HI......I am popping in late on this covo......and thanks to Shane, we understand what caloric weakness means!!!

I would suggest u get to a chiari specialist and let them tell u whom else to see.Having the right dr for chiari can aid u in some of ur other issues.

Since I do not know more about u ....that us all I can add at this point.But I do hear ur frustration with the medical field.....we can all relate to that.

"selma"
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921053 tn?1245180795
Also, is it my ears or is it my eyes???  Should I see and optometrist or opthomologist???  Any recommendations???
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921053 tn?1245180795
Is it possible that this caloric weakness is related to the chiari malformation???  Is there any way to correct this condition??  Even with this result, the neuro ENT still thinks it is a neck issue!!!  (DUH...my brain is sinking into my neck)  I think I am going to go to medical school and "practice" medicine like all these doctors do with us!!!!  
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Avatar universal
Yeah my daughter had that done during her vestibular testing. I did not realize that was what it was called. Hers came back normal along with the rest of the tests so that is why they feel her dizziness is caused by something else like a certain kind of migraine.
Thanks for that info. You learn something new everyday.
Chadry
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555358 tn?1292532061
One of the balance/dizziness tests you had was where the ran water into your ear canal. During this test, your eyes reacted poorly compared to the norm. This is one of the reasons you have bad balance.

This reaction is called caloric weakness.
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Avatar universal
I am very curious myself as to what that means. Maybe someone here will give a good answer to that one.
Glad to hear you are getting some relief and you have a PT that you feel comfortable with. I know when I was injured on the job I had a few PT's who would do whatever the W.C. doctors told them whether or not it caused more pain for me. I finally had one that flat out refused to do some of the stuff they wanted him to do with me. I have a few messed up discs in my neck and lower back and he felt the things that they wanted me to do were just not possible. I was so happy that I finally had someone on my side. It made a big difference when I had to go to therapy. I was not so afraid that I was going to be in more pain when I left.
Chadry
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