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Vestibular Nerve, Dizziness, Balance issues
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Vestibular Nerve, Dizziness, Balance issues

I have had episodes dizziness/vertigo off and on for the last 6 months. It's been quite frustrating, I have explored the entire gamut, from Meniere's disease to vertebral artery issues to cervicogenic dizziness, cerebellar tonsillar ectopia  to the latest has been ossified posterior longitudinal ligament that becomes calcified.

They all seem to have similar symptoms. The most disturbing part is the sensations of dizziness and unsteadiness. My gait is shortened(unless, I’m intentional when walking). I’m 50 yrs old but feel like I’m 80 with regard to my ability to walk or move fast.  If I close my eyes I loose my sense of where I am in space. Yesterday, I was in a grocery store, standing walking and as I panned the room turning my head to the left and thought I would fall over. I have a bad cold now which has added more noise to my plugged ear. The one constant symptom I’ve had for I don’t know how long (at least 7 months) is noise and hear loss. I have evidence that my vestibular nerve is damaged.

I’ve tried to get back to see my neuro but he does not recognize this as urgent and therefore recommends that I return in 2 months. No elevated BP, no heart problems, no brain issues, MRI shows nothing, MRA – unremarkable.

1) is it possible that I had some kind of seizure that has done some brain damage?
2) is there some way therapeutically to heal my vestibular nerve on my left side? that seems like it plays into my loss of balance. I can feel instability in my feet(as though my feet are two small) but they are not.

Avatar_dr_m_tn
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, if your 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.

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 these. 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.

Based on your description, your symptoms do seem to be peripheral (inner ear). It is difficult to say if you have had a seizure in the past or not. A normal MRI is reassuring.

If you have not done so, I would recommend that you obtain vestibular rehab. This is a specialized physical therapy focused on coping and treating dizziness. You should also continue following up with your neurologist.

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

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