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Eye Muscle Problem?
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Eye Muscle Problem?


  About 3 weeks ago I noticed my left eye started to feel loose and I began to have balance problems and dizziness. When I gaze at a stationary object now it will appear to be shaking slightly. My eye will twitch up and down when I open my eyelids fast. I went to my PCP and was treated for the dizziness as a possible inner ear infection (10 days of antibiotics) without success. My PCP got me an appointment with a Neuologist for next week.
  My question is, would it be possible that the muscles in my left eye suddenly got strained, pulled or damaged somehow and that is why my eyeball feels loose? Or could an eyeball become loose from a lack of control from some other neuological problem like an ear infection, etc.? Could someone become dizzy by simply having a weak or strained eye muscle? If this is a eye muscle problem should I be seeing a Opthamologist instead?
  How can a neurologist (or I) tell the difference between a weakness in the eye muscle itself or the nerves controlling it?
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Thanks for your question.  Although it is possible for your symptoms to be
caused by a partial paralysis of one of the external eye muscles (which moves)
the eyes, it is much more likely that the problem is located in the "input"
side of the Vestibular System loop (also calles Vestibular Ocular Reflex).
The "input" organs are indeed located in the inner ear, and they are formed
by the semi-circular canals, utricle, and saccule.  These organs sense
movements in the angular direction (e.g. spinning around in a chair), and
also linear accelerations (e.g. accelerating/braking in a car).  It is
quite frequent for a minor viral infection/inflammation to cause mild
impairment of such organ, thus causing inappropriate "movement" signals
to be sent to the brain.  Another location of impairment of the "loop", and
this one of more serious consequences, would a lesion in the Vestibular
Nuclei located in the brainstem.  These nuclei are the "integration center"
for the balance information, and they can be lesioned by brainstem hemorrhages,
infarcts, or other lesions.  Usually, vestibular nuclei lesions are associated
with other brainstem lesion signs, and your neurologist can make a determination
of whether such signs are present or not.
I hope this information of helpful.  Best of luck.





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