Dizziness, Eye Pain, Cough Headache

Dear CCF Neuro:

I would like to ask a few questions.

My problems began in Dec. 98 when recovering from the flu. I developed an intense "cough headache", which lasted approx 4 weeks. During that time I started experiencing episodes of dizziness/vertigo (not an adequate description). This sensation was very intense but did not cause loss of balance or coordination.
These episodes increased in frequency and intensity during those weeks and I determined that there were two types. The first was linked to body temperature, which seemed to oscillate through a normal range about every two hours. The higher the body temperature, the more intense the sensation. At it's peak, I was experiencing 40-50 episodes/day. Episodes lasted 1-10 minutes. The second type was triggered visually, apparently by changes in lighting, and lasted only seconds.
After the cough headache disappeared, both types began to decline steadily (at noticeably different rates). The first faded gradually over 4 months (body temp returned to a normal daily cycle over the same period). During these months, I experienced a lot of tinnitus but not in direct correlation with the dizziness episodes. I also experienced episodes of "seeing stars" during exertion. These bright points of light would appear to move quickly around in my peripheral vision for about 10 seconds. These episodes occurred about 3 or 4 times per week.
Blood work, hearing and eye exams were all normal. About May 99, I began having episodes where I felt as if I were bouncing up and down (sometimes quite violently) and my doctor referred me to a neurologist. The neurologist said it was not MS but that my vestibular system had become sensitive and prescribed some exercises involving moving quickly from laying down on one side to the other. The only effect of these exercises was a possible increase in the frequency of the "bouncing" episodes.
By Feb. 2000, the visually triggered dizziness and tinnitus had faded completely. "Seeing stars" occurred perhaps once per month.
About May 2000, I began having short intense stabs of pain above my ears. These pains lasted only a second and seemed to come in sets of three over a period of a few minutes. This occurred perhaps once every three weeks.
In Sep. 2000, I got the flu again. Just as I thought I was getting over it, I got the "cough headache" again. Visually triggered dizziness returned and increased while the cough headache was present. Neither was as severe as the original back in

[CCF Neuro[P]-M.D.-RPS]

Dear John:

Sorry that your having such problems.  It is difficult to tell you what is exactly going on.  Usually we think of vertigo (the room or person having a spinning sensation) to have difficulty with the inner ear.  Light headedness on the other hand can be due a number of things from hypotension to inner ear problems.  One needs to make the distinction.  Having the onset of symptoms together with a recent flu suggests that you might have had a viral inner ear infection or other viral related process.  I do think that you need an MRI to help sort out what is going on.  Cough headache or exertional headache can be isolated (usually will resolve within a few years) or associated with hindbrain problems with the syndromes or entites you mentioned.  The MRI will help sort out most of these.  Yes, pain and dizziness (depending on which type as described above) can co-exist and be from the same disease.  There are a number of these and without more information I can't speculate (but reoccurance of Herpes can be one).  Again, I can't answer the last of your questions completely but a post viral demyelination could cause lasting but remitting symptoms as you have described.  

So, I would wait and get the MRI, and then try and see if this doesn't help your physicians sort out what is the cause of your problems.

Sincerely,

CCF Neuro MD