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Neurology (Expert Forum)
central vestibular abnormalities
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central vestibular abnormalities
by young at heart, Nov 05, 2006 12:00AM
I recently had a ENG/VNG and the results came back with balance test showing signs of central vestibular abnormalities.
This reports says I have abnormalities with oculormotor movements with delayed saccades.as very as a very jerky pendulum swing.I recently developed this.
It continues to state that I have a peripheral vesibular disease with the central vestibular abnormalities.
I have MS my question is does this all go back to the MS or are these two seperate entities.I have mild bilateral hearing loss and tinnitis.I do not have vertigo or dizziness,I do however get off balance and get disoriented in the dark.The ENT suspects possible brain stem lesion or left cerebral hemisphere lesion.I had an MRI a week before the ENG/VNG the lesions were in the occipital region.Could of the MRI w/without enhancement missed the lesions.
MS is fairly new to me I was diagnosed in June of this year but had partial transverse myletitis in 1998 in the lumbar region.Any insight would be greatly appreciated.
This reports says I have abnormalities with oculormotor movements with delayed saccades.as very as a very jerky pendulum swing.I recently developed this.
It continues to state that I have a peripheral vesibular disease with the central vestibular abnormalities.
I have MS my question is does this all go back to the MS or are these two seperate entities.I have mild bilateral hearing loss and tinnitis.I do not have vertigo or dizziness,I do however get off balance and get disoriented in the dark.The ENT suspects possible brain stem lesion or left cerebral hemisphere lesion.I had an MRI a week before the ENG/VNG the lesions were in the occipital region.Could of the MRI w/without enhancement missed the lesions.
MS is fairly new to me I was diagnosed in June of this year but had partial transverse myletitis in 1998 in the lumbar region.Any insight would be greatly appreciated.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Nov 14, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms you describe of hearing loss, tinnitis (ringing in the ears) and off balance feeling (worse in the dark) is most consistent with a peripheral vestibular disease. Given your diagnosis of multiple sclerosis (MS) you will have chronic "central vestibular" findings on ENG/VNG. There are chronic white matter changes that occur in the brainstem that affect a structure called the MLF that helps coordinate eye movements. You do not need an "active" lesion in the brainstem to cause these findings. A BAER (brain-stem audio evoked response) may add some additional information. Central vestibular symptoms include vertigo (room spinning) without relation to head/body movement and double vision/jerky vision.
In addition to getting the BAER, a pulse of steroids (solumedrol) would improve a possible MS lesion and would also calm inflammation in a possible vestibular labrynthitis.
I hope this has been helpful.
The symptoms you describe of hearing loss, tinnitis (ringing in the ears) and off balance feeling (worse in the dark) is most consistent with a peripheral vestibular disease. Given your diagnosis of multiple sclerosis (MS) you will have chronic "central vestibular" findings on ENG/VNG. There are chronic white matter changes that occur in the brainstem that affect a structure called the MLF that helps coordinate eye movements. You do not need an "active" lesion in the brainstem to cause these findings. A BAER (brain-stem audio evoked response) may add some additional information. Central vestibular symptoms include vertigo (room spinning) without relation to head/body movement and double vision/jerky vision.
In addition to getting the BAER, a pulse of steroids (solumedrol) would improve a possible MS lesion and would also calm inflammation in a possible vestibular labrynthitis.
I hope this has been helpful.
