can neuralgia cause vertigo?

[LynnSB]

I wrote many months ago about my earface pain/offbalance problem.STILL no diagnosis or help and I have new symptoms.I've finally gotten a referral to a neurologist and would appreciate any feedback,ideas,things to ask about.Sporatic basic neuro exams since this started in April by my internist are normal. Background:in April while working at computer felt strange,like falling into my computer.stood up, felt off balance weird.soon noticed(next day I think) ears hurt. went to doc,said both eardrums retracted, low wbc, probably a virus.Felt deep, burning,sort of itching pain in left cheek.May,ran high fever, chills, left ear pain,palate pain, constant light headedness.  took zithromax.soon felt great but within days dizzy,same area low on left cheek,half dollar size, became red, hot, swollen.could not get in todoc, stayed swollen and puffy. went to dentist, found no abcess (abscess) but a "dead tooth",had root canal.fluid came out of tooth.all pain in face and ear went away-for a while. dizziness remained. had vestibular testing, normal, MRI, normal except"chronic small vesseldisease.Sept. 5 -developed room spinning vertigo, nausea.horrible,lasted hours.went to er- had CT scan. Normal. NEVER ANY NYSTAGMUS either.now have constant almost pain in left ear,cheek,gnawing,deep,itchy.had sinus CT scan,normal.I feel lightheaded almost all the time, brief "spurts" of room spinning,usually when bend forward or tilt head backward.new dental exam,normal.left ear hurts sometimes terribly, always told it'snormal.sometimeshurts to touch inside with a q tip.sore area in mouth left of palate.ANY IDEAS?

[CCF-Neuro-M.D.-JT]

Dizziness is one of the most common problems we see in neurology clinic and can be quite disabling for the patients. Although there's a long list of things that can cause vertigo-like symptoms, the specific cause is not found in up to 50% of cases. Glad that your MRI was normal and did not show any serious neurological diseases. Your symptoms sound like they could be benign positional paroxysmal vertigo (BPPV) as they are provoked with positional changes. ANd although you state there is no nystagmus, I'm not sure if you mean with neurological exam and positional maneuvers or just that you don't notice any.  Here at the Cleveland Clinic, we have a dizzy clinic run by Dr. Oas who uses special devices and computers to pick up nystagmus that we can miss with the naked eye to help him make the diagnosis of of BPPV.

There are three main groups of diseases that cause dizziness,
1)ones that are localized to the vestibular organs (like the inner ear structures) which are caused by things like trauma, recurrent ear infections, tumor, BPPV, Meniere's disease,drugs etc...
2)ones that are localized to the brain or brainstem, caused by things such as medications, stroke, migraines, MS
3)systemic causes such as thyroid disease, diabetes, vasculitis, infection, and anemia.

A neurology consult is a step in the right direction. They can help review your list of medications, clinical history, and perform a neurological exam to pinpoint where the problem may be and what the appropriate treatment should be. GOod luck.

[LynnSB]

the only thing that helps the pain is high dose ibuprofen (800mg) and, curiously, sometimes the left side of nose runs-realy runs -- clear liquid as the pain subsides. Yet I'm told my sinuses are fine. I've also been to a psychiatrist ( who has known me 7 years) and she insists this is NOT anxiety, not psychosomatic. Also saw a cardiologist twice, and had a thallium stress test in July  - normal.My dentist has 30 years of experience, has xrayed me until I'm probably radioactive ( hahaha)and spent an hour poking and knocking and touching my teeth with ice, heat, etc . and finds nothing wrong. I am so tired of being treated like I'm crazy and making this up because I have no nystagmus. something, SOMETHING happened to me in April/May and whatever that was left me dizzy, with chronic weird pain in my ear/cheek and feeling awful generally. by the way, an ANA, CBC and sed rate were all normal ( done last about a month ago).