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Neurology (Expert Forum)
Re: dizziness
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Re: dizziness
by cf-neuro-MD, Jan 01, 1995 12:00AM
Posted By ccf neuro M.D. on May 25, 1997 at 21:02:23:
In Reply to: dizziness posted by GILL on May 14, 1997 at 15:39:36:
: Dear Doctor
I have been treated twice in the past year for labyrinthitus. But for several months now I have suffered with dizziness, mainly when I lie down or tilt my head to the side or lean back.
I was sent for a hearing and balance test but this was clear and I was prescribed with the same tablets as for labyrinthitus. I have a feeling of pressure on the top of my head, which feels as if I
am carrying a heavy weight around. It is worse if I bend down, travel in a car or eat. I sometimes have shaky blurred vision which only lasts seconds.
I recently had blue hands although a blood count proved o.k. I don't know if any of this is connected.
Please help.
It sounds from your description that you have a symptom known as vertigo, a specific type of dizziness that makes one feel as if the room is spinning around. Sudden movement of the head or changes in position, even as benign as simply turning one's head while asleep, often trigger it as these things all stimulate the flow of endolymphatic fluid in the semicircular canals of each inner ear. With such persistent symptoms, it may be worth obtaining ONE single MRI of the brain and internal auditory canals WITH AND WITHOUT CONTRAST to exclude any serious condition such as a tumor known as an acoustic neuroma, or a stroke or other disease that may affect the parts of the brain that maintain balance. Provided that this is normal, as it most likely will be, you may have a condition known as BPV--- benign positional vertigo. This problem, interestingly, is easily diagnosed by a bedside test called the Hallpike maneuver and has been shown to be treatble by a series of simple sudden movement of the head and neck known
as the benign positional vertigo treatment maneuver, that has an astonishingly high rate of success in eliminating the condition--- even better than drugs!! This treatment maneuver could be performed by most neurologists, as well as a thorough neurologic exam to try and detect evidence of any more serious condition. Other possible diseases you could have include psychogenic vertigo (the weird sensation of pressure on your head is somewhat suggestive that this may be a possibility in your case, although this is always a diagnosis of exclusion), and a conditon known as Meniere's disease, which consists of horrible attacks of vertigo and tinnitus (roaring of the ears) in combination with progressive hearing loss on the affected side---- doubtful in your case given the normal hearing test. At any rate, any good neurologist could help you sort out the exact nature of your vertigo or dizziness. If you would be interested in being seen at the Cleveland Clinic Department of Neurology, our number is 216-444-5559, or 1-800-223-2273 extenzion 45559. I hope this information is useful to you.
In Reply to: dizziness posted by GILL on May 14, 1997 at 15:39:36:
: Dear Doctor
I have been treated twice in the past year for labyrinthitus. But for several months now I have suffered with dizziness, mainly when I lie down or tilt my head to the side or lean back.
I was sent for a hearing and balance test but this was clear and I was prescribed with the same tablets as for labyrinthitus. I have a feeling of pressure on the top of my head, which feels as if I
am carrying a heavy weight around. It is worse if I bend down, travel in a car or eat. I sometimes have shaky blurred vision which only lasts seconds.
I recently had blue hands although a blood count proved o.k. I don't know if any of this is connected.
Please help.
It sounds from your description that you have a symptom known as vertigo, a specific type of dizziness that makes one feel as if the room is spinning around. Sudden movement of the head or changes in position, even as benign as simply turning one's head while asleep, often trigger it as these things all stimulate the flow of endolymphatic fluid in the semicircular canals of each inner ear. With such persistent symptoms, it may be worth obtaining ONE single MRI of the brain and internal auditory canals WITH AND WITHOUT CONTRAST to exclude any serious condition such as a tumor known as an acoustic neuroma, or a stroke or other disease that may affect the parts of the brain that maintain balance. Provided that this is normal, as it most likely will be, you may have a condition known as BPV--- benign positional vertigo. This problem, interestingly, is easily diagnosed by a bedside test called the Hallpike maneuver and has been shown to be treatble by a series of simple sudden movement of the head and neck known
as the benign positional vertigo treatment maneuver, that has an astonishingly high rate of success in eliminating the condition--- even better than drugs!! This treatment maneuver could be performed by most neurologists, as well as a thorough neurologic exam to try and detect evidence of any more serious condition. Other possible diseases you could have include psychogenic vertigo (the weird sensation of pressure on your head is somewhat suggestive that this may be a possibility in your case, although this is always a diagnosis of exclusion), and a conditon known as Meniere's disease, which consists of horrible attacks of vertigo and tinnitus (roaring of the ears) in combination with progressive hearing loss on the affected side---- doubtful in your case given the normal hearing test. At any rate, any good neurologist could help you sort out the exact nature of your vertigo or dizziness. If you would be interested in being seen at the Cleveland Clinic Department of Neurology, our number is 216-444-5559, or 1-800-223-2273 extenzion 45559. I hope this information is useful to you.
