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TBI and Vestibular Issues
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TBI and Vestibular Issues

Three years ago, i somehow survived a fall, somewhere around 18 feet, head first, directly onto concrete. My skull split down the seam between the two plates, and also split the frontal plate down to the bridge of my nose. I landed on the rear of my head, and the rocochet-effect split the frontal plate, severing my olfactory nerve, damaging my ocular nerve (which left my left eye looking off somewhere other than my right eye), and also permanently severed the tactile sensations to my right foot. After four months, i was able to walk again, somewhat, and it was almost a year before my mobility got back to normal. My left eye also came back into normal control, although i suffered from double vision for several months. Overall, though, everything considered, i feel lucky to be here and almost (almost) back to where i was pre-TBI. However, i do continue to have periods of extremely severe vestibular malfunctions, causing weeks of motion-sickness if i move a single muscle. When these periods aren't apparent, there is absolutely no problem. I can run, swim, bike, do pretty much everything i used to do. Excessive speeds on the bike do cause bad vestibular sensations, though. I apply the brakes going downhill, and that takes care of the issue. There seems to be a fairly regular pattern to these vestibular breakdowns, though. I have gone through several stretches of vestibular rehab therapy, but from everything i can tell, my brain will get to the "good" point regardless of whether i do the therapy, or not. Every three months seems to be the timeframe for the relapses, and within the past year, these have been accompanied, or perhaps triggered, by high fevers of 102, 102, and 100.6. The most recent episode wasn't accompanied by any fever, but we have been going through a summer of weeks of 100+ temps outside. Maybe the TBI caused an inability of my body to handle high body temps, and it causes my VOR to stop working if my brain has to divert its energies to handle the body heat. OR, the other hypothesis is alcohol. I don't drink much, and never have, but the better i feel, the more prone i am to more normal, typical behaviors such as drinking a beer or a glass of wine once or twice a week. I haven't yet tracked the correlation between consumption of alcohol and the onset of VOR relapses, but it is the theory de jour. I've decided to test this theory by not drinking any alchohol at all, just to see how much time lapses before my next vestibular relapse. I should also mention that my neurologist has gone through all the normal, expected tests one goes through after a TBI, and last week, he admitted that he's out of suggestions for what to try next. His prescription for Topamax only made things 100X worse, so i stopped that after only 4 doses. Other pills for motion sickness don't help, either. My vestibular therapist thinks that the problem is more ocular, and is a case of visual vertigo, but even he admits that he doesn't know how to treat that, because the science behind it lags tremendously behind the more traditional theraputic treatments for BPPV. I'm at the point now of wanting to give some other clinic or hospital a try, given that my professionals here have run out of ideas. Before i do that, though, this seems like a sensible place to get some advice and perspectives on what i should or shouldn't be doing to address my vestibular issues. Those issues in a nut shell are, the regular, clockwork timing and severity of the lapses of my equilibrium, potential triggers for those lapses, and treatment options. Today is a good day, but i know from history that it is only a matter of time before i'm flat on my back again. Any comments are appreciated.
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