How do I know if my vertigo requires steroids?

[starryeyes1]

I am diagnosed with MS and always have balance issues, but starting Thurs night I got off the couch to go to bed and I literally felt like I was on a roller coaster ride. My stomach felt like it was dropping, my head was spinny, and even when I put my head between my knees it didn't go away.

I went to bed and when I sat or laid down I felt fine. If I stood up, turned my head at all my stomach would again feel like I was on a ride at the fair. The next day, I thought it was gone, but it came back and I've had it all weekend. I started to think that it was sinus related due to pressure in my face when I lay down. I have Amoxicillan and even tho I've taken them for 2 full days I am still super dizzy and have headaches and pressure in the back of my head.

I called my neuro on Friday but he is in Washington and I am in Arizona. I don't have a neuro here because of my bad experiences with them not knowing this disease. I am moving back to Wa when my husband gets back from Iraq. His nurse said my Dr couldn't call steroids in from another state. I'm not sure the Urgent Care will be able to help.

If I need steroids, I will need to go to the ER which usually takes 6-8 hrs to be seen. (no lie!!)

And- are they gonna know what to do with me? I don't feel convinced that people here understand MS. That is why I went a yr and a half from Dr to Dr and finally to an MS Specialist out of state.

I am just wondering--How do I know if this is something that requires steroids? I've never had them before and I'm nervous about the side-affects. I've never had this type of spinning before.

Does anyone have advice or knowledge regarding the vertigo?
Thanks in advance!
Kristi

[supermum_ms]

Hi and welcome,

1 brain lesion without any other identifying information is not on it's own suggestive of neurological conditions like MS or even classified as being abnormal in most circumstances. For 1 lesion to have placed a neurological conditions like MS on your list of possible causes, the lesion would need to be more specific to demyelinating conditions eg enhanced with contrast, size, shape, consistent locations etc.

Vertigo is a very commonly reoccurring medical issue - There are different types of vertigo and there are many different associated conditions but it is also a stand alone condition. I believe the most common type is Vestibular neuronitis which is a very sudden debilitating vertigo with associated unsteadiness, nausea, and vomiting, either they or their surroundings are spinning and more commonly caused by a viral infection of the vestibular nerve and or labyrinth, steriods known to aid early recovery.

The second common type is Benign Paroxysmal Positional Vertigo (BPPV), there are many different variants of BPPV but its basically a mechanical problem within the inner ear, some of the inner ear crystals become dislodged and migrate. It causes a spinning sensation lasts only a few minutes and often stops by itself, triggered by head movements, things like rolling over in bed, tipping the head to look upward, bending over, generally the cause is idiopathic (unknown), vestibular training is the first treatment but Steroids eg prednisone may be prescribed if nerve inflammation is a possibility.

note: BPPV will NOT cause constant dizziness, affect hearing, fainting, headache or neurological symptoms such as numbness, pins and needles, speaking issues or cause movement issues.

To be honest there isn't really anything normal about how MS first presents, the most common issues that leads to someone being diagnosed with MS are actually visual eg Optic Neuritis, Nystagmus, and unilateral paresthesia eg numbness, pins and needles. With vertigo being such a common issue in the general population, the odds are in your favour that what has happened to you is not due to a neurological condition like MS.

Hope that helps............JJ

PS: I probably should point out that i was a little wary of responding after reading your post history, this community is definitely not aggressive or confrontational in anyway and many would likely be reluctant to respond in case you didn't agree with something they may say.....we will always be respectful, please respond in kind. ta

[HVAC]

Then you had inflammation that is what steroids work on.

Alex

[vender]

I had vertigo for 4 month with no DX.  The neuro had me go for a steroid infusion and WOW! finally relief.  I know this is old but I am so happy I had to share this with others.  I am going back for two more. This is a miracle for me.  I have just one brain lesion and am in a wait and see time? Is this normal if its MS? The beginning?

[starryeyes1]

Well officially its been 5 days w/ vertigo. Its off and on. Mostly I feel nauseous all day. I talked to my neuro and he had sd to wait to make sure it wasn't a sinus thing. I've been on Amox since Fri and feel like I should be better by now if it was sinus.

Since I've never had vertigo or steroids, I don't know how bad it has to be or how long it has to last before I should have steroids. I also get headaches. Is this common with vertigo?

Praying for better days...

Kristi

[sg40]

Hi. I can't tell you whether or not you should try steroids, but I can tell you I just finished my third day with no adverse side effects. I had some very mild facial flushing, but that was it. I was terrified of the potential side effects, but had to try something. My nurse said most patients she administers Solumedrol to have little to no side effects. I can not say that you will not- but if you need to feel better and steroids may help, it may be worth the chance. Good luck to you - please let us know what happens.

[Celery47]

Hi there!  I just wanted to say that I hope you feel better soon - that sounds pretty rough :(  If steroids might give you relief, I think you maybe ought to go chase some down, give 'em a try.  I don't know much about MS or dizziness so I don't think I'll be much help there... but I can say, I was super freaked about steroids and all the scary listed side-effects but then I finally broke down and took some when some migraines got out of control - and for me, anyway, it was totally okay and definitely worth it.  The only side-effect I had was this weird shivering.  It wasn't really uncomfortable or anything, just weird.  I was really glad I finally took the steroids; the relief was pretty awesome.  

Whatever you end up doing, I hope all that dizziness gets better soon!  Hmmm - and I don't know if the doctors in the ER will know what to do with your MS (that whole situation sounds frustrating - I'm sorry!) - but it seems to me that ER doctors are usually willing to hand out a course of steroids to just about anybody.  So even if they don't really know all the details, I bet they'd give you them.  Good luck to you!!

[rendean]

Kristi,
The no taper is what my doc said he was comfortable with so I'm not sure what your personal doc will decide. The steroids did not increase my BP to any significant level so maybe it won't bother yours.

I think calling your neuro for advice is very good idea!!! Let me know how things go.

Feel better,
Ren

[starryeyes1]

I am already dx with MS. I have high blood pressure so does that mean I wouldn't use the taper off drugs? I didn't know BP was affected.

How long did you wait before going in for steroids? You said you had it for 2 months? I am going to call my neuro again tomorrow morning to see what he says to do.

Thank you so much for your response!
Kristi

[rendean]

Hi, I can't tell you when you need steroids per se but I can tell you about my experiences with vertigo and steroids.

I had vertigo for the better part of 3 months last summer. I went through 2 rounds of IV
steroids before I got relief. The deciding factor in my case was when I starting falling and injuring myself. I could not walk unassisted.

As for side effects, my steroids were for 3 days only and no taper due to preexisting hypertension. I did not have any noticeable side effects other than insomnia and moodiness similar to PMS. A sleeping pill took care of the insomnia and patience from my family handled the mood swings.

Are you dx with MS? I'm sorry I can't keep up with who is and who isn't dx anymore :-)

If you have a dx then an ER should know what to do and have a neurologist of some sort on call at all times. Do you  have a PCP? You could start there and rule out other causes.

Sorry, I know I'm not much help but I can empathize with you!! Last summer was the worst I have ever felt. Give me my natural childbirth experiences back...they were more pleasurable.

I wish you well in your decision making and truly hope that the vertigo subsides soon!

Ren