dizziness

In 1994 I had a laparoscopy for a suspected ovarian cyst.  I seemed to have trouble waking up from the anesthesia but the surgery seemed otherwise routine.  I went home the same day and still seemed very groggy.  The next day while getting a drink of water I had a severe dizzy spell and almost fell to the left.  Since that time I have had constant motion sickness, dizziness and loss of balance.  I have seen several physicians and even psychiatrists to no avail.  The only thing that has been found is a small atrial septal defect and small ventricular septal defect with no enlargements.  The doctors decided to leave them as they are for now.  Yearly MRI's since the onset of my symptoms have showed a capillary telangiectasia on the pons in the brain stem (no apparent TIA's or bleeds). My  Neurologist feels this is not the cause of dizziness.  I have had vestibular testing at a major facility in the U.S. which was negative. I have no pain in my ears or hearing loss. The dizziness is so severe that at this point I am virtually home-bound.  I can't even drive to the grocery store with out becoming sick.  The only other symptoms I have are orthostatic hypotension (tilt-table was negative because I didn't faint).  I also had both my appendix and part of my left ovary with large cyst removed in 1985.  Could adhesions be causing these symptoms?  Is there a surgical complication that could be linked to my dizziness?  Is there any other medical condition that you may be aware of causing this?  I appreciate any help you may be able to provide.

Thank You,

Skylar

[Kevin Pho, MD]

You have been through a very thorough evaluation for the dizziness - including vestibular testing, MRIs and a tilt-table test.  

It is unlikely that adhesions would be causing the dizziness.  I am unaware of a surgical complication that may lead to the symptoms.  A side effect from the anesthesia is a possibility, but the symptoms are unlikely to last that long.  

Audiometry, brainstem evoked audiometry, and electronystagmography are all tests that I would consider to further evaluate the symptoms.  Brainstem evoked audiometry has a 90 to 95 percent sensitivity for detecting acoustic neuromas.   Electronystagmography (ENG) tests vestibular function by using electrodes to detect either spontaneous or induced nystagmus. It has a reasonable sensitivity for vestibular disorders.  You may have had some of these tests during your vestibular testing, but if not, it should be discussed.  

If the neurology route is not revealing, you may want to consider a second opinion with a neurologist at a major academic medical center or an otolaryngologist.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.