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rebound nystagmus vertigo and headache
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rebound nystagmus vertigo and headache

I am a 35 year old male with a "basically" normal MRI MRA and MRV of the brain, and MRI of cerv. spine. And normal blood tests.  I also had a normal Video-Nystagmogram(?)-the one where water is squirted in your ears as the camera record your eyes..this too was normal (a terrifying test as I became severely dizzy).  

I have had--a constant non throbbing headache, on the top of my head, and the front of my head mostly.  I have also had--extreme dizziness in a horizontal position, that the room will not stop spinning until I stand up again.  This will also happen if I'm standing but I tilt my head back/look up.. These "episodes" as I call them usually last a few days at a time then I am not so dizzy for a few weeks or so.

When I am dizzy any movement of my eyes will seem to aggrivate the symptoms,   and, I seem to get what I think "might" be what I understand to be rebound nystagmus..when I look my eyes in either direction, and look forward again, the room "bounces around" for a short while.   The movements of my eyes in either left or right direction feels stiff.  Can you please..help..I have seen 3 neurologists.
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Avatar_n_tn
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 that you describe are consistent with BPPV (benign paroxysmal positional vertigo) with some migraine headaches as well.  Dizziness/vertigo can be broken down into 2 basic causes, problems in the ear/vestibular canals gives rise to peripheral Dizziness/vertigo, and the brain/cerebellum gives rise to central Dizziness/vertigo.  Peripheral vertigo is more likely to be positional (changes with position) and is also more likely to be intermittent.  Central Dizziness/vertigo is constant despite positional changes and gets progressively worse overtime (for example: a brain tumor or stroke in the cerebellum).  It sounds like you have had a good work up (MRI/MRA/MRV) to evaluate for a central cause of your Dizziness/vertigo, and it is normal (as I would suspect).  The difficulty in finding the reason behind your symptoms with peripheral Dizziness/vertigo tests (such as the video-nystagmogram etc) is that your symptoms are intermittent and if you are not having your symptoms at the time, it will be hard to diagnose.  BPPV is most often caused by otoliths (pieces of calcium/debris) that break off in your vestibular canals and cause the wrong signals to be generated. These otoliths work there way out of the canal with time and the symptoms resolve, at least for a while.  There is also a series of head manipulations (Eply maneuver), which can often provide relief to patients with BPPV by moving the otoliths out of the canal.  Patients with vestibular problems also often have chronic neck problems.  These neck problems then give rise to headaches due to contraction of the muscles in the neck that pinches nerves (such as the greater occipital nerve) and provides a trigger for the headache.  
For the symptoms that you describe I would suggest a prophylactic medication against headaches/muscle relaxant for the neck called tizanidine (zanaflex).  This is a daily medication and will help (after 3-4 weeks) to calm down the headaches.  I would also suggest neck physical therapy, by a physical therapist that understands the role of the neck in headache disorders.  If/when you Dizziness/vertigo symptoms reccur I would present to a neurologist for the eply maneuver and possible trigger point injections if any focal areas of tenderness are found in your neck region.  
I hope this has been helpful.
9 Comments
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Avatar_n_tn
Hello

I have the VNG test set up for next week.  How bad was it.  From what you wrote I am now scared to take it.  Did the dizzyness subside after a while and how bad was it.  I am getting nervous now thinking about it.  
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Avatar_n_tn
I don't want to scare you, but for me it was pure hell...We had to stop the test twice before i could finish.  I got bad vertigo during the test.   The thing that allowed me to hold on and finish was that each ear only lasts 30 seconds and I was re assured that the dizziness caused by it was benign and would go away after a few minutes...which it did.
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Avatar_n_tn
thanks but it is scaring me.  Sometimes guess its better to not know what to expect.  I am just more nervous, sometimes when the dizzyness happens nerves can than bring on  a naseuas feeling.  Goodness i am now thinking of canceling,  
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Avatar_n_tn
what are your symptoms that you're having it for?  The best news is that no matter how dizzy you get during the test, it is benign and it'll definately go away.
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Avatar_n_tn
Sounds a lot like bppv (benign paroxysmal positional vertigo).  This is a spinning type dizziness which happens when your head is in certain positions, i think looking up is quite a commone one, there is even a name for this (top shelf syndrome or something like that).

bppv is caused by crystals forming in the canals in the inner ear that control balance.  There are exercises you can do to dislodge the crystals.  Any ENT specialising in dizziness/balance will know about this.

Of course it might be something else, dizziness can be caused by all sorts of things.

  
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Avatar_n_tn
Constant headache that never goes away (frontal and right side of head) with a very prominent sypmtom that happens sporadically throughout the day which is fluid filling up in my ears again mostly right side. After the fluid drains into my ear it than rings for quite a while. I know someone is missing something on my films.  Went to a neurototolgist who is doing a few different test right now.
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Avatar_n_tn
I have also suffered from Vertigo for quite sometime, I have been poked and proded on several times and various test ran. Most Vertigo does come from your ears however if your still experiencing problems, have an MRI done. This showed that I have Central Vertio basically means that its a nerve in the brain that controls it. Which meds like meclazine will not help. Talk with your doctor and ask if they have checked that option on you. As for the nystagmus problems you can try to excersize your eyes, again your doctor will have that info for you. If you have any questions that I can help with. Please let me know.
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Avatar_n_tn
Maybe it's a type of ocular migraine? I have basilar migraines where I am so severely dizzy that I cannot walk by myself for days. They thought I had benign vertigo syndrome for awhile when I first started- before the migraines changed and gave me more recognizable symptoms. Good luck, my friend. All of us with neurological problems are like the "mystery illness" people.
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Avatar_f_tn
A related discussion, How common is Horizontal Nystagmus Vertigo? was started.
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