Re: Dizziness

Posted By CCF Neurology MD:NT on October 09, 1998 at 22:29:41:

In Reply to: Dizziness posted by Nancy on October 08, 1998 at 18:20:28:






: : : I have been suffering from dizziness for over 15 years.  The last few years it has become a chronic problem.  I am seeing a neurologist for the problem. I've had several MRI's that were basically normal.  There were some areas that were questionable for early MS, but that was a few years ago and there have been nochanges.  My neurologist gave me a diagnosis of "UNcompensated vestibular deficit"  I've gone through vestibular rehab, with some relief.  The dizziness will subside, sometimes for months and then it comes back with a vengeance.  I really don't understand it.  I've been told that I possibly had a virus or something that caused the flareup.  I wasn't sick at all at the time.  I am so frustrated.  It's ruining my life.  I've suffered from panic attacks because of it, too.  Help!!! My neurological exam is negative. I don't suffer from any specific  weakness, just generalized fatigue.  Does his diagnosis sound plausible?
: : : Thanks
: : : N




Dear Nancy:
The fact that you have have suffered no major neurological consequences despite have had the symptom of vertigo for 15 years should be very reassuring. Whatever your problem is, it is very benign!
The inner ears are like a pair of ultra-sensitive gyroscopes. Vertigo results from inner ear problems when there is a mismatch of sensory information from the two sides. This wears off with time when the brain unconciously learns to compensate for the difference or mismatch. "Uncompensated vestibular deficit" is a hypothesis that simply means that your brain may have failed to compensate. Vestibular exercises actively help your brain to relearn to compensate for the mismatch.
Persevere with your exercises.
Good luck!



     =

Dear Nancy:
What you describe is not exactly clear to me. Abnormalities of eye movement with passive head movement needs to be interpreted with caution, and in the right context (eg. if your eye was fixated on a distant fixed object, or to an object that moves with your head, such as an extended arm). Also, whether or not you felt the environment jiggle or not ("oscillopsia") with head movement is important. To an experienced neuro-otologist, these features may be very useful markers of a vestibular (inner ear) or brainstem/cerebellar problem. I do not know what a "weakened" eye muscle may mean in your situation.
You may benefit from consultation from a neuro-otologist in a mjor acdemic center near you. In case you live near Cleveland, I can strongly recommend Dr Oas at the Cleveland Clinic. An appointment can be made by calling [phone], or [phone] locally.
Good luck!




Dear Nancy:
I am sure you understand the limitations of this forum as a means of diagnosing and treating your specific problem. I have nothing further to add.