Dizziness

My wife is 46 y/o and has had a bout with feeling off balance and dizziness for the past 10 days. She first had symptoms of a fullness and loud sounds in her left ear and decreased hearing. She visited our PCM and was place on Z-Pac and Sudafed, but no infection was noted. After 3 days of the medications, no relief, so my wife scheduled an ENT appointment. She was then placed on Prednisone. After about 5 days she started to feel like her heart was racing, so we went to the ER, no cardio issues were found but the doctor did say she had an ear infection. She contacted the PCM and was started on Cefprozil after about a day or two of Cefprozil the dizziness got worse. She completed the Prednisone but discontinued the Cefprozi after the dizziness got so bad. After all this she is still very dizzy, with a swaying sensation and feeling like she can't control her lower extremeties. This has been emotionally draining on her. We have a MRI scheduled but vey confused.

What do you think?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I am not sure what you mean by the term dizziness. When some people use the term dizziness, they often mean vertigo, or room-spinning. Others mean a light-headed, whoozy feeling.

If by dizziness you mean vertigo (room-spinning), the causes could be either the inner ear or the brain. Inner ear causes of vertigo most commonly include benign positional vertigo (BPPV), which is due to small particle in the inner ear that moves out of place, and can be repositioned with simple head maneuvers. The symptoms often include vertigo that occurs with turning of the head, often while turning over in bed. Another cause, since your wife’s symptoms are associated with tinnitus (ear ringing) and hearing loss is called Meniere’s disease and can be treated with medications and sometimes surgery. And so on, several other causes from inner ear problems exist. These can be determined by an ENT.

Vertigo can also be due to problems in the brain. The most common is a benign tumor called a schwanoma (also called acoustic neuroma). This is diagnosed by MRI of the brain. Multiple sclerosis can cause vertigo, but often, other symptoms are present as well. A normal MRI of the brain excludes multiple sclerosis. Thyroid problems can also lead to vertigo.

If by dizziness you mean light-headedness, causes could include low blood pressure such as due to dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes. Anemia can cause light-headedness as well.

These are just some of the possibilities of your wife’s symptoms. I would suggest that she follow up with the ENT again for further diagnostics and management.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.