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405614 tn?1329144114

What to do about dizziness?

I've noticed that a lot of us deal with dizziness/vertigo.  I'm wondering if I should do something more about mine.

Yesterday at physical therapy, my PT worked on my neck, which increased my dizziness somewhat, though not as bad as in the past.  She then took me to the gym to try a new exercise to strengthen my gluts, saying that I needed a strong platform in order to keep my neck from being so constantly rigid, tight, guarded, whatever she called it.

She had me stand on a box, put my weight on one leg, and reach behind me with my other leg, tap the floor, bring the foot up without touching the box, and repeating 10 times.  By #9 on the second leg, I totally lost my balance, fell sideways off the box, landed on my left leg (tweaked my bad knee), stumbled across the gym sidestepping until I wrapped both arms around the front of an exercise bicycle.

My wee PT tried to catch me, but I was falling and stumbling; at first she thought I was joking around, she said.  Then she was horrified, and glad that I didn't hurt myself.

My knee now yelps at me with normal walking (my ACL{second replacement} is already loose and thinning), and doesn't help with balance issues any.

My question is what can I do about my dizziness?

A few years ago my otolaryngologist said that he could do a test to see if I had BBPV, but that would just show if moving me around caused my vertigo to be worse.  He gave me some low-dose Xanax to take, which helped very little, if any.  The last time I tried it, it actually seemed to make things worse.

He said that my dizziness was not from my allergies.

I called him after my brain MRI showed all those lesions, and asked if  my dizziness/vertigo could be caused my MS.  He hemmed and hawed, said it was possible, since some people with MS did experience dizziness, but it was difficult to say, since he's not a neurologist, yada yada.

Since we've had discussions here about peripheral as opposed to central vertigo, I'm wondering about tests such as a VNG or others I can't remember now.  None of my neuros have thought my dizziness extreme enough to be of any concern to them, but since it's messing with my life, I'm thinking that maybe I'll bring it up with a little more emphasis at my next appointment with my MS specialist next month.

Or do I see a new otolaryngologist?  Any ideas, suggestions?  

Thanks,

Kathy
30 Responses
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Avatar universal
Do you still feel the same?  I feel it everyday of my life.  
Helpful - 0
2069248 tn?1347002510
I understand this subject on this forum is 3 years old but I am at my wits end trying to find some relief from my debilitating dizziness caused by my MS which I am certain of the cause because it is what initially got me to the doctor to get an MRI and then I was diagnosed with MS and My Neurologist at the time said according the amount of damage done and the age of the damage it looked like I had MS for 15 to 20 years.

I suffer from sever fatigue as well and I take Adderall to combat this. Adderall helps sometimes but it also exacerbates the dizziness so its a "catch 22". It seems the only thing that helps is shutting my eyes for at least 15 minutes every hour or 2 and that is no way to live IMO.

Anyone have any suggestions or further insight on dizziness and MS and how to possibly treat it given my circumstances that I described above?

Thanks,

Erik
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667078 tn?1316000935
You might want to start a new post. Just go up to the top and hit post a question.

Alex
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784382 tn?1376931040
i been dizzy for months now and have no answers......i dont wanan live like this anymore =(
Helpful - 0
400099 tn?1282954864
I had the vestibular therapy and the vertigo resolved immediately! It was wonderful. (epley maneuver). The vertigo was awful. I'm very lucky that it worked. Now, I just get run of the mill light headedness and dizziness. When it's particularly bad, I take mecclizine (antivert).
Helpful - 0
751951 tn?1406632863
Welcome to the neighborhood.

How "new" is the new neuro?  Did she order the two prior tests?  If not, a gentle reminder might help straighten her out.

Laura Lu, I always figured having a cane made me into a tripod, or maybe more like a milking stool.  Anyway, I topple a lot less with that third point of ground contact.  Interesting perspective you've brought in there about the sensory hints.  I guess that's proprioception via the palm of the hand?
Helpful - 0
Avatar universal
I've had dizziness and vertigo off and on for the past 12 years. I have been dx'd w MS, but my new neuro wants to do an ENG/VNG each time I have an episode. I've had two in the past year and I'm currently having another episode, I called her and she wants me to have another test. I just had an ENG/VNG the end of October which showed the dizziness was caused by the Central Nervous System which is consistent with MS
. My symptoms are always the same. I've been treated with high dose steroids for a few of the worst episodes and that has always helped. I saw my Otolaryngologist today and he did not see any reason for me to have another test and just prescribed the steroids. I think I'll just cancel the test. It costs my insurance $500 each time they do the test. It seems silly. I've been having this for years. It's never been an ear problem my symptoms are always the same.
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Avatar universal
One more thing about canes and hand fatigue.  An ergonomic handle makes a huge difference for me.  I had to shop around a lot to find one for the right hand and finally got one on the web.

(Most are for the left hand, a supplier told me, because most people prefer to keep their right hand free for carrying things.  But my left foot is less steady than my right, so I prefer a cane on the right, even though my right hand goes numb at the drop of a . . . cane.)
Helpful - 0
572651 tn?1530999357
Just to add to the discussion about canes -  in the past week or so I was reading about canes (as usual, I don't remember where, sorry!) and learned a bit more how they work for us with MS or other similar disorders that affect our ability to walk-

the sensation of the ground felt by the cane travels through our hand and gives the clues to our brain as to how to step appropriately.  This is a message that is not always clearly relayed by our feet or legs.  All along I thought a cane was for the extra strength in walking and it turns out it is more for the neurological clues that it provides.

I hope this makes sense,
Lulu
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751951 tn?1406632863
My cane has been my best friend for several months.  Sometimes I don't really need it, but if I go across the room without it, you can just about bet i'll need it to get back.  It is a lightweight adjustable metal one that I bought at Walgreen's, I think, for maybe 15 to 20 bucks.  And of course, it's basic black.  My wife has one with pink roses printed on it from top to bottom, but that just wouldn't look so good for me stepping up to the pulpit.
Helpful - 0
405614 tn?1329144114
I also feel that my dizziness/balance issues are mild compared to many others I've run across.  Whenever I'm in a flare where the balance issue is worse than usual, I find myself checking out cool looking canes that people are using, or I see in a store.

At this point, I think the only thing that stops me from getting one is the fact that I have a lot of pain in my right forearm, and it fatigues easily when I'm in a flare.  I think that I would bruise people more than my ego right now!  

I'll adjust to one if it becomes necessary; so far my bruises are fairly mild. :o)  I suppose those lightweight hollow metal ones are best for my arm pain, but I've seen some gorgeous hand-carved wooden ones... they cost too much, but it would be art!

The PT that I saw on Friday made a note in my chart about the fall, and she understood how frustrated I was by lack of diagnosis/ treatment, and did some great soft tissue work and listening.

My regular physical therapist (saw her this morning) gave me an alternative exercise to do to replace the one that caused my fall.  She also faxed a note to my PCP regarding my balance issues.  I'll ask my PCP to forward it to my neuro.

Kathy





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Avatar universal
It's not that I'm *glad* to hear so many share this dizziness and some of the ways I deal with it, but it is good to know I'm not alone.  I always wonder whether I've posted something obvious or patronizing, especially since my situation is mild compared to many others in this group.

One tip I'll consider is getting that laptop cat!

As for the cane, Fluffysmom, the biggest issue is starting.  It's an ego bruiser, no doubt about it.  It does slow one down.  But that could be a benefit if bumping into walls is an issue.  Just a thought.
Helpful - 0
405614 tn?1329144114
Ha!  I missed the laptop; my cat is only a laptop if I get up and pick him up after he meows and snags my jeans for a while!

I have the computer across the room from the bed, which has been known to be my Command Center on bad days.

Kathy
Helpful - 0
405614 tn?1329144114
Wow, I knew there were a lot of us with dizziness/vertigo/whatever you want to call it!

Jensequiter, I did tell them about my balance issues/dizziness at PT, and they said they would do an evaluation at the next visit.  A different PT filled in, and had me walk up and down the hall, looking at a list more than at me, and do a few other things.  I guess since I didn't actually hit the floor, I was deemed fine.  Even after I told them about the day I left there feeling like my brain was floating above my head...

My knee is easily tweaked; I lost my balance in a restaurant a few days before this incident at PT and banged the patella on a chair; Arnica time!

I'm seeing a different PT this morning, and I'll ask her if she's more familiar with the balance testing.  She did really great at helping my knee and lower back pain the one time I saw her before.

Pastor Dan, I appreciate the advice on terminology; maybe my neuro will pay more attention if I catch it with the right words.  I also appreciate your sense of humor; taking up riding a bike to cure baldness!  Actually, i think I saw an infomercial for that!

I rarely get queasy enough to lose weight.  I did for a few weeks, but then I ate for comfort and gained the lost pounds back, doggone it!

Ess, I hope this is your last bout of vertigo.

Terry, I'll be interested in hearing about the results of your VNG.

Octarine, I've tried Meclizine, Scopalamine, and Xanax; I think the Scopaline may have helped some, but that was years ago.

I pretty much follow your list already; I only have to fill up my gas tank about once a month, and that's always under 8 gallons.  I don't have a cane (yet), but I tend to stay near stuff that I can catch myself on.

I've cancelled appointments before because I didn't feel safe to drive because of that light-headedness you describe.  I've also arranged to have a friend pick up my prescriptions, drive me where I need to go, etc.

Your Command Center is a good idea, too!  I have a bag that I put all my stuff in if i need to move from one location to another; don't need to be lurching around for stuff on a bad day!  I tend to step on Fluffy's scratching post, misjudge distances and hit my head on stuff or corner poorly when going into another room; need bumpers on the walls!

Thanks for the good ideas and all your personal stories.

Kathy

I was on the BRAT diet for a while after a virus of some sort, so when I'm feeling queasy I'll eat the more bland, easy to digest food, too.
Helpful - 0
152264 tn?1280354657
Octarine--I love your Command Center! Mine is pretty much the same except that instead of a laptop computer, I have a laptop cat. :)
Helpful - 0
Avatar universal
My dizziness is a sort of lightheaded world-not-behaving-right issue, made worse when I turn my head and look sideways (as in changing lanes on the freeway).  As with my other symptoms (and I'm not Dx), it comes and goes.  But when it comes, so do other things and it's pretty miserable.  

The ENT vertigo evaluation said it's not peripheral.  The PT evaluation (very cool series of tests on what appears to be a prototype Wii) also said not peripheral, with a few key deficits pointing to central, but not enough to impress my neuro.

But what Fluffysmom wanted was advice!  Here's how I handle it:  I tried Meclizine, but like PastorDan, I don't like the sleepiness it causes.  So I adjust my behavior:

1.  I don't drive at night or long distances any more.  This screwed up a volunteer effort I was doing, but also has resulted in new friendships with people I recruit to drive to concerts and plays.
2.  I don't drive at all on bad days.  If a dizzy day starts mid-day, I find a ride.  Fortunately, two people in my department at work are my neighbors and close friends.
3.  I use a cane on bad days.
4.  I take it easy on bad days.  And no knife work in the kitchen.  My child is good at opening cans and using the microwave, and doesn't mind the occasional dinner of breakfast cereal.  
5.  I eat the BRAT diet (bananas, rice, applesauce, toast) for stomach upset, with broth and sometimes yogurt.  Like PastorDan, my appetite is shot on these days and easily digested food is a comfort.

Are you seeing a pattern? My strategy is to accept this limitation and ask for help.  That's not easy.  I've been a very active, very busy person and when I've planned to get some things done and wake up to a dizzy day I often get angry.  But I try to be kind to myself, take a forced vacation, and remember that there will be good days again.

The other thing that really helps is something I learned first from nursing babies and later relearned with a broken ankle.  I make a Command Center out of a reclining chair, portable phone, pad, pen, books, magazines, laptop, water, snack, tissues, blanket, etc. Assuming there's no nystagmus that day (preventing reading), I can get a lot done in the Command Center.  

But I'm lucky in not having constant or severe vertigo like you and PastorDan and so many other members.  Are any of these ideas useful to you?

Oh, and do be sure to follow up on that fall in PT..  
Helpful - 0
152264 tn?1280354657
The vestibular PT that I saw (many years ago) said "There are some people I know I can help, some I know I can't help, and you?... well, it's worth a try." But she said it rather doubtfully, and said that my neurologist (a dizziness specialist) was just "poking up the vestibular tree," so I wondered if that meant he didn't know whether my dizziness was inner ear or brain. He never really said one way or the other.

I have heard another vestibular PT say that many people with MS can be helped to improve their balance after an exacerbation. So, PT might be worthwhile.

I remained dizzy after PT but I did have less sensitivity to watching movement, such as traffic. My balance was never much affected at all, just head-dizziness. I stabilize myself with my feet.

Ess: one part of the 3-part ENG/VNG involves watching moving lights while your eye movements are recorded. I think this is called the ocular motility portion of the test. I am by no means an expert on ENG/VNG, but I think this is the part that can show central involvement.

Although BPPV is unrelated to MS, I did hear one vestibular PT say that MS patients have it more frequently--I'm not sure whether that's true. (I never heard it elsewhere.) And there wouldn't seem to be any reason for such a relationship, since BPPV occurs from otoconia (small crystals) breaking off from an inner-ear balance organ and getting into a semicircular canal, which seemingly has nothing to do with the CNS.

Anyone wishing to try an Epley maneuver at home can Google "hain dizziness bppv", click on the first page that comes up, and scroll down the page to find an explanation and illustration of the home Epley. Just be careful if you have neck or circulation issues!!

Regarding dizziness during caloric irrigation of one ear versus the other, we hear from a balance-testing expert that symptoms during that part of the ENG don't really mean anything. So, they can't tell anything from whether you did or didn't get dizzy during the water/air-in-the-ears test. What is important is the eye-movement recordings.

Kathy--I will send you a PM.

Nancy
Helpful - 0
648910 tn?1290663083
I recently had the VNG.  I am waiting on the results.  I don't think it is my inner ear because the part of the test where they cover the goggles and swing you back and to the side did not make me dizzy, indicating the thingys  :0)  in my ear are working fine.  However the nystagmus was rampant.  Every test I could feel my eyes moving around.  The caloric test was the only part that made me dizzy to the point it felt like vertigo and he said that was normal.

I do take balance training at PT.  It has improved my stationary balance with my eyes open...eyes closed nothing has changed, I sway like a tree in the wind.

terry
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751951 tn?1406632863
Oh, I didn't mean to imply that it wouldn't help anyone.  It didn't help me at all, but I've heard from others that it often does.
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751951 tn?1406632863
Hmmm.   My ex neuro was a loser, and sent me to a PT who DID specialize in vestibular rehabilitation therapy.  Actually, he told me what kind of PT to find, and let me do the searching.  She really seemed to do all she could, but in reality, there was just no notable effect from four weeks of therapy.  I haven't seen the lesion that causes this, but I can't help believing it's in there somewhere, and has nothing to do with the vestibular system, but is making my brain think there's a vestibular imbalance of some kind.  It's like trying to take up bike riding to treat baldness, or changing the TV channel because you don't like the taste of your supper.
Helpful - 0
338416 tn?1420045702
In my opinion, your PT should have evaluated you for balance and vertigo before she decided to give you that particular exercise!  That's just ridiculous.  Now your knee is injured on top of your other problems... sheesh.

There are PT exercises that can help you rehabilitate.  Vestibular something or other...  I think it involves retraining the brain so you can find your center.  However, your vertigo and your lack of balance are two different things.

MS can definitely cause vertigo.  I have a lesion in my cerebellum, which my neurologist thinks is causing my vertigo.  You can also lose proprioperception with a lesion in the spine.  Mine eventually went away, and nothing I tried worked...  just time, and patience.

My balance issues still remain.  If I close my eyes, I don't know which way is up.  I have to lean against the shower stall when I'm washing my hair so I don't fall over.  I don't know if they'll ever go away.  My neuro is a loser, and thinks that PT won't help my balance issues... so here I go to find another...  I've been saying that for four months, haven't I?
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Avatar universal
I feel as if I invented the rocking boat. Move over, Noah.

This is my third bout of this kind of vertigo. When I'm sitting or lying down things are perfectly normal. When I get up and move, holy moley. Mostly side to side stuff, with the floor rocking' around the Christmas tree.

In about 2 weeks I have a VNG scheduled. I think this will show only whether or not the problem is peripheral. I don't think it can detect abnormalities in the CNS, so if my neuro doesn't believe me now (and who knows?), he's not likely to be convinced by a negative VNG.

However, Quix is our vertigo expert, so perhaps she'll join in here. She's had BPPV for quite a few years, and has been treated by the Dr. Epley who invented the technique named for him. BPPV is a peripheral issue only, so it's coincidental that Quix has this and MS as well.

ess
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405614 tn?1329144114
I'm on my third year of allergy shots.  The doc (Dr. W.) that sent me for them is the otolaryngologist that said the only testing he would do was for the BPPV.  I do my own shots, and recent testing shows that they're really helping.  

I'm not diagnosed with MS, my MS specialist hasn't thought much of my dizziness/vertigo.  I will ask her about a ENG/VNG when I see her next month.
The time I saw her with my worst symptoms, her chart notes didn't reflect that I had any abnormalities in my exam except for my tremors in my upper extremities.

I almost fell when trying to walk on my toes, walking heel to toe, etc.  I figure she just filled out my template at the end of the day and didn't remember anything about my exam except the tremors.  My reflexes were more pronounced than usual, etc.  

That day she told me that my symptoms were coming from my cervical spine, but were not outstanding enough to call for a new spinal MRI until spring.  Well, it's Spring!  

At my next visit, she came up with a theory that is sending me to see my cardiologist from 2003 to have him review my records and hopefully tear apart her theory that my PCP thinks is full of holes.

As for a vestibular PT, it's difficult to find a PT that can work with my multiple physical issues without hurting me, so I'll have to research carefully to make sure a new PT understands multiple issues.  Maybe I should have the ENG/VNG done first.

Another dizzy day here... and I'm going out to dinner with friends of a friend that I don't know very well.  A challenging but fun evening, I'm sure!  

Kathy
Helpful - 0
152264 tn?1280354657
Kathy, haven't you had an ENG/VNG yet? If you have an ongoing problem with dizziness, I'm kind of surprised. On the other hand, if you are diagnosed with MS, I suppose they would want to ascribe your dizziness to MS. But it's possible to have MS AND inner-ear trouble too, I'm sure.

What might be most helpful, from a practical standpoint, is to find a PT who SPECIALIZES in vestibular therapy. Check the Vestibular Disorders Assoc. search feature.

At least one neuro-otologist in this area DOES believe that allergies exacerbate dizziness that is due to inner-ear problems--he even provides allergy shots in his office. I did this for two years (even though I would never have guessed I had allergies, but their testing said I did). It may have helped--but, as always, the dizziness gets worse again. Better, worse, better, worse, better, worse...

Nancy
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