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transient loss of vision and vertigo
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transient loss of vision and vertigo

I am sorry that the Headache category is not relevant since I  cannot select a topic as my physician and I do not know my diagnosis.

I am a 46 year old, healthy female, with Hx. of seasonal allergies (tested and documented), major concussion age 9, of average weight and height, normal blood pressure, low LDLs, high HDLs, no psychiatric Hx., identical twin with migrane (migraine) disorder, but I have been experiencing transient vertigo/dizziness and 2 blind-outs while driving, and rapid collapses without blackouts, which seem to coincide with allergies, for which I am effectively treated (??)  

The first episode occurred in 2005, as I was driving home on the highway from work on a sunny, spring day, as the sunlight was flickering in my peripheral field.  My vision turned grey, and the pixels of my visual field became distoted, and I lost vision for 10 seconds while driving in the fast lane on the  beltway.  Since then, in the spring/summer, I have had numerous (4x/week avg) bouts of transient dizziness/vetigo while driving at high speed and and 2 episodes of sudden drop (I think it's called) whereby I was just talking to someone, and I lost my ability to stand, think, converse, and see.  It happens so fast that it almost feels like sudden electrical imbalances in my brain.  Again, this was very temporary and I do not lose consciencness, but I did suddenly drop to the ground.  I can almost reproduce this sensation by inducing the environment, that is, driving at highway speed, playing music with a lot of base or high tenor, using my electric toothbrush, etc.,i.e., producing vibration.  

Now, May 21, I had another "big one" today, albeit transient, but enough to stop me for a moment in my car.  Also, when I am driving myself to work, my children to and from school and events, the continuation and non-diagnosis is indeed quite concerning and after 3 years of this, I am in need of a dignosis and treatment.

I have worked at Johns Hopkins Univ. Sch. Med., Univ. Maryland Sch. of Med. and now at the Children's Hopital in DC as a statisicam/epidemiologist for the past 24 years.  I have had the opportunity to learn (in detail) the nuances of Psychiatric Genetics, Genetics, Pediatric Cardiology, Brain imaging, Neuropathologic Research, Cancer Research, Retinal Disorders Research, HIV, and currently, supporting all research at the Children's Hospital in DC.  Needless to say, I have a very experienced and supportive group of friends, colleagues and my physician who have tried to help me through the years, at pinpointing my diagnosis and determining effective treatment.

I have had MRI, EEG, full ENT workup, cardiologic, opthalmologic and neurologic work ups and all are completely normal, migrane (migraine) w/out headache has also been ruled out after a temporary trial of Topomax (topamax), without relief.

I feel that increased vibration and intermitent light exposure invokes these transient events, but that does not explain the few instances of sudden drop.  My internist is at his wits end and keeps ordering new referrals and tests.  I am frustrated and am in need of additional, professional guidance.  
I sincerely hope that someone out there can share their similar story, but at the same time, I am sorry that you would have to experience this too!

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147426_tn?1317269232
Wow.. I'm sure nothing I could offer here would be something that you and your colleagues haven't thought of, but I'll throw out my thoughts even though they were most likely the first thoughts of everyone else.

You describe the symptoms of syncope - loss of sufficient blood flow to the brain with dimming, graying and distorted vision.  Clearly the drop attacks did not have such a warning.  I also gather there was no ensuing headache.

I'm sure you did, but did you have a tilt table test for cardiogenic syncope?

Is your hearing normal?  Do you have any ringing, buzzing, static, noise in your head?  Does your hearing fluccuate? Have you had an ECoG?

The other phenomenon that I think of is the "Drop Attack" a sudden loss of postural stability without loss of consciousness.  Usually one thinks about it in the context of Meniere's Disease, but I found some interesting discussions on it on some vestibular sites.  At the bottom of this post are some links for you to peruse and ponder.  Your feeling that the triggers seem to include respiratory allergies, light and sound also sound like the offending organ may well be your vestibular system.  The light flickering between trees as we drive through wooded areas sends me into a tailspin of vertigo.  Sudden noise pressure will do it.  You may someday see me on the news for having blown the head off the driver with the 8 subwoofers sitting beside me at the light.

I have had drop attacks, but mine were clearly vertiginous in origin.

I also came across this old posting in the archives of MedHelp from 1997

""Posted by CCF NEURO MD on June 04, 1997 at 11:36:10:

In Reply to: Central Vestibular disorder with Visual conflict and Motor coordination problem post-acoustic neuroma surgery posted by Barbara Pease on May 30, 1997 at 00:47:54:

: I have been diagnosed thru a posturography test with a possible central vestibular disorder with visual conflict and motor coordination problem, post-acoustic neuroma sub-occipical approach tumor removal 11/93. I have drop attacks (loss of muscle tone) of unknown etiology. This seems to be triggered by eye scanning and visual and/or audio conflict. An EEG/MRI/MRA has ruled out seizures, vascular problem. MRI shows no damage. A sleep study has ruled out narcalepsy. I am looking for someone who specializes in this post-acoustic neuroma surgical complication. Are their any further tests that can be done, and can the Cleveland Clinic help me and how?
Thank-you for taking the time to help.
Warm Regards,
Barbara ""

This isn't you is it?  Though it describes someone with a specific vestibular injury (removal of an accoustic neuroma of the ear) it could easily apply to anyone with significant vestibular injury.

Have you seen a neuro-otologist for a complete vestibular work-up?  I'm sure one of your affiliated medical centers has an excellent one.  Also you can get info on Vestibular specialist at VEDA  - vestibular.org

Here are a couple links.  If none of this is new or helpful, please respond and I will think further.  After all I'm sure that you haven't had what I can offer....a complete Pediatric work up!  lol....

http://www.balance-and-dizziness.com/tumarkin.html

http://www.dizziness-and-balance.com/disorders/central/drop.html

Keep me posted, Quix


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147426_tn?1317269232
Yes, I, too, hate it when I become stupid in front of colleagues :).  Also, though I appreciate your thanks, I am, indeed, a physician, so do not qualify (kidding here also).  I am a retired/disabled general pediatrician.  My knowledge comes not only from that, but from the extensive reading I have done from being disabled by two separate neurological illnesses: Chronic, Autoimmune Inner Ear Disease and, most recently, MS.   I also did the clinical half of an Immunology/Allergy post-MD fellowship at UCLA.  I am not a neurologist and can only offer ideas from a tiny window into the black box that is anyone who posts on a forum like this.

While we always want to roll all compaints into one neat diagnosis, in reality we have to be prepared to find more than one thing wrong.

In evaluating the drop attacks - they sound like they are different from your "near syncopal" episodes which have slower onset with definite symptoms.  I can't be sure.  You deserve evaluation for the entire spectrum of things that cause people to fall out...stroke, seizure (as in partial complex), cardiac, electrolyte, atypical migraine, vestibular, etc.  You've had eval's for several of these.

You need to see a cardiologist and describe your episodes.  Attacks from an entity called cardiogenic syncope (also called other things) can be serious, causing head injuries or injuries from LOC during activies such as driving.  I have to say knowing that you drive while in the middle of these episodes is concerning.  Anyway of finding help with that?  The diagnosis often involves the "Tilt Table" test which is done to look for abnormal cardiac activity during positional changes.

I was serious when I discussed the similarity of many of your symptoms to subtle and not so subtle abnormalities of vestibular function.  Just before you posted, I posted a discussion on vertigo here on this forum.  It was written for laymen and so may be well beneath what you already understand.  If sorry.  If you want to read it here is the link:

http://www.medhelp.org/forums/NeuroSupport/messages/1976.html

I return to this point because all of the input that you describe is important info that is also precessed through the vestibular portion of the inner ear.  Flickering light (or visually confusing environments), heavy sound pressure, especially pulsating sound, vibration to the head, acceleration and deceleration are all potent stimulants to the vestibular organ.  (For example the receptors for acceleration are in the semi-circular canals of the inner ear).   If that organ is damaged or irritated these stimuli can cause small and annoying or enormous symptoms like the ones you describe.  People with chronic vertigo also consistently complain of increased symptoms at times of allergy flares.
Personally all of those remain triggers for me all the time.  I relocated to a new region 5 years ago, so my allergies have been quiescent, but the few times they have flared, so has the vertigo.  

The only people I have found that truly can evaluate the subtleties of the vestibular system are in a sub-specialty of ENT or Neurology called Neuro-Otology.  I explained in my prior post how to find one, but your colleagues should also know.  General ENT's and general Neuro's all say they know how to evaluate it, but, in my experience, few really do.  I didn't see mention of an ENG (Electro-NystagmoGram)

You are in great hands, being so close to medical researchers.  And I may be way off base with my ideas.  I often am, but I did want to shae my observations that you put together some good data that points toward a needed vestibular work up.  Did you read the postings I gave you for discussions of "drop attacks?"  

If you answer, may I ask that you not use all caps?  I have trouble with my eyes tracking and have a great difficulty reading things in CAPS.  Thanks.  I really hope you can get to the bottom of al this.  I would NOT write them off as aberrations secondary only to your allergies.  They are far too serious.

Good luck, Quix
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Avatar_n_tn
Many thanks, Quix.  No- I am not Barbara; this is my first posting to this forum.
Are you a physician?  If not, I am grateful for your thoughtful advice.
Some answers to your questions IN CAPS:

You describe the symptoms of syncope - loss of sufficient blood flow to the brain with dimming, graying and distorted vision. Clearly the drop attacks did not have such a warning. I also gather there was no ensuing headache.  HARD TO SAY IF IT WAS FROM INSUFFICIENT BLOOD FLOW BUT THAT IS ENTIRE PLAUSIBLE.  HOWEVER, THIS WOULD NOT EXPLAIN THE VERTIGO WHILE DRIVING, THE MATTER OF WHICH IS INDUCIBLE.  I HAD NO WARNINGS BEFORE THE DROP ATTACK, AND NO HEADACHE AFTERWARDS.  MIGRANE (migraine) W/OUT HEADACHE HAS BEEN RULED OUT AND THE TOPOMAX (topamax) WAS ONLY EFFECTIVE IN DIMMING MY THOUGHT PROCESSES 9BECOMMING STUPID), AS NOTED BY COLLEAGUES.

I'm sure you did, but did you have a tilt table test for cardiogenic syncope?  ACTUALLY- I DID NOT HAVE THIS TEST.  PERHAPS THIS WOULD BE A LOGICAL NEXT STEP.  DO YOU HAVE THIS DISORDER?  IF SO, HAVE YOU BEEN DXED AND EFFECTIVELY TREATED?

Is your hearing normal? YES- THAT WAS TESTED.
Do you have any ringing, buzzing, static, noise in your head? NO.
Does your hearing fluccuate? NOT REALLY, EXCEPT WHEN THE KIDS ARE FIGHTING I TURN IT COMPLETELY OFF (LITTLE JOKE)
Have you had an ECoG? NO, ACTUALLY I DON'T KNOW WHAT THAT IS.
THANKS SO MUCH FOR THE RESOURCES AND ADVICE.  I WAS FINALLY SUCCESSFUL IN GETTING MY INTERNIST TO TREAT THE ANXIETY THIS HAS PRODUCED SINCE TWICE THIS WEEK, I ATTEMPTED TO DRIVE TO WORK BUT HAD TO TURN AROUND AND COME HOME.  AS IN YEARS PAST, I EXPECT THIS TO RESOLVE IN JULY OR SO.


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Avatar_f_tn
I started having chills and dizziness that doesn't go 1 or 2 days after getting the H1N1 vaccine. Is now 4 weeks. I started having severe dizziness, inability to maintain balance, light headedness that progresses to heavy, sleepless night, nausae, transient dizziness that goes and come back in less than 1 minute, confusion, tingling on my both feet and my hands.
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