Doctor calling the vertigo a suspected MS attack

[lovemy6monkeys]

I saw the doctor this morning and he said I'm having true vertigo. The nystagmus is now in both eyes. He had me walk down the hall and I veered to the left. He had me stand with my feet together, arms straight out in front and close my eyes, and I started to drift backwards.

He said there are two reasons for true vertigo, an ear problem or a brain stem problem. He checked my ears and said they were perfectly fine so that leaves the brain stem.

He said that an MS attack will get worse in the next day or so, so if I get worse at all I need to come in so he can give me the IV steroids. And, I guess if it gets worse then he will consider it a real MS attack.

I feel like I'm standing in the doorway of a diagnosis, but I'm too scared to ring the bell. All along I've been wanting to find out what is wrong with me, and put off really thinking too much about the consequences of what MS will mean. I'm a bit blind-sided by the prospect of IV steroids.

My doctor said if I get worse then the side effects of the steroids on me, being undiagnosed, are minimal compared to the side effects of not treating a true MS attack. He said if he doesn't do the steroids then it will leave me with a "deficit". I asked what that means and he said I would have lasting balance issues.

I'm a bit nervous about the steroids. Can anyone give me some ideas on what side effects I might have if I end up needing them? How long does it usually take? Would I only need to go in once?

Thanks for any help you can offer!
~Jess

[vender]

DO IT!  Get the steroids. It has saved me. I dont care right now about side effects as I had vertigo for 4 month and it got worse by the day.  After one round of IV infusions I felt a BIG difference.  They worked wonders on me.  I am going back for two more and don't care about side effects or the fact it doesnt help MS long term.  It has made life WAAAY better!

[immisceo]

This thread is six years old.

[patientx]

Several years ago, about 2.5 years before I was diagnosed with MS, I had a few days where I was suffering from vertigo.  It was like being seasick, and, though I didn't vomit, I had this constant feeling like I was going to.  I went to the doctor; lacking evidence of anything else (they did a CT scan, but no MRI),  he diagnosed it as benign positional vertigo, maybe caused by a virus.  Looking back, this may have been a first sign of the MS.

Like others have noted, vertigo can be an inner ear problem.  Looking in the ears might rule out an obvious infection, but I don't think it can rule out all causes of vertigo besides MS.  Did the doctor suggest trying one of the anti-nausea medicines, like antivert or dramamine?

In any event, it sounds like you are giving the steroids a try, so hopefully this will tamp down the vertigo.

[lovemy6monkeys]

Thanks Lu!

My doctor gave me a whole mess of pills...ok, only 3 prescriptions but it feels like a bunch LOL. The prednisone, of course, and also prilisec to help stomach irritation, and a sleeping med. I can take one or two of the sleeping pills, so late night I took one along with my normal 300mg of neurontin. It helped without completely knocking me out.

I go back in a couple hours, and I think they will have to put in a new IV line. Mine has a dark bumped up bruise where it goes in, and some blood in the line. So, I'm drinking a bunch of water in an effort to hydrate my veins. I have horrible veins LOL

Thanks!
~Jess

[Lulu54]

You'll do fine with this Jess. Remember that the steroids will probably leave you amped up a bit - perhaps even having troub le with sleeping.  From what I know, you may feel a bit strung out, too - remember this is all temporary and taking the IV steroids will perhaps help to reolve the problem sooner rather than later.

good luck and let us know how it goes, ok?

Lu

[lovemy6monkeys]

Thank you all for your advice and thoughts.

The spinning feeling went from just every once in a while to feeling it most all the time by this afternoon. I called my doctor and we decided to try the steroids. I think if my youngest was older, or at least walking, I'd probably decide to wait, but right now I don't even trust myself to hold her :-(

I'm a stay at home mom, and while I do have the option of taking it easy, I still need to care for the kids, and I'm not able to do that right now. I'll admit, I hate, hate, hate this! I hate taking medicine (I've refused pain meds since I was diagnosed with degenerative disc disease 3 years ago) and I just hate doing this, but I trust my doctor and if it is what he recommends then I'll follow his advice.

I did happen to ask him about the "true vertigo" statement when I saw him again this afternoon. He said the nystagmus and the fact that I was feeling the symptoms even without moving my head is why he checked my ears just to rule out an infection, etc.

My husband will be home for at least tomorrow, possibly wednesday too, and my awesome younger sister stopped by while we were at the doctors and stocked my freezer and left a gift card to a local pizza place, just so I didn't have to cook this week. I'm very lucky to have both of them to support me!

Thanks everyone for your advice.
~Jess

[rendean]

I have suffered from vertigo as an MS attack. Last summer it lasted almost 3 months. I did 2 rounds of IV steroids that helped with the vertigo enabling me to stand upright versus crawling on the floor.

My vertigo was dx as central vertigo by an ENT, a neuro-otologist  and a neurologist. The steroids did help to a certain degree. What I don't understand is your doctor's statement that without them you would have a deficit. I disagree with this statement in the same vein as daisy.girl. Steroids only help to end the effects of the attack sooner but have no outcome in the long term prognosis of MS.

My decision to do IV steroids was made due to the fact I was home alone most of the the day and the constant nausea and vomiting from the vertigo was something I had little tolerance for.

The side effects from a 3 day  steroid treatment were far and away minimal compared to my symptoms of vertigo which included several falls onto hard tiled floors. I did experience mood swings, metallic taste in my mouth (so therefore I didn't gain any weight since nothing tasted good) and insomnia which was helped by a an RX for Ambien.

The decision to take steroids is a personal one. In my opinion, the deciding factor is how much the vertigo is interfering with your day to day functioning. Ess made a very important regarding your doctor's dx of central vertigo with out doing any of the caloric testing, rotatory chair testing etc. Perhaps the nystagmus in both eyes is what he is basing his dx on. I, too, had bilateral nystagmus when I had my episodes of central vertigo.

My advice is to discuss this first with your husband and see how he feels about you being able to take care of the kids, since he knows you the best and knows when you are capable of something and when you are not. IMO, the side effects were not enough to deter ME from taking 2 rounds which finally brought the horrible summer to an end.

Do what is right for you and your family. Also, I would get your doc to explain how he came to his conclusion that it was MS causing the vertigo.

Wishing you luck with your decision! I hope this settles down soon, I know how miserable you feel.

Hugs,
Ren

[essdipity]

Jess, I agree that this is an individual decision. It depends on whether you are able to function adequately without steroids. With 6 little ones, maybe not, I don't know. I do think that steroids should be used only in more extreme circumstances, since you don't know how often you might need them in the future. High doses of IV steroids can lead to osteoporosis. Oral steroids aren't much good in MS relapses.

Your doctor sounds proactive, all to the good. However, some things he told you leave me wondering. It's not possible for any doctor to look at your ears and eliminate them then and there as the source of vertigo. There are specific tests for that, done usually by an ENT. Also, there is no way for him to know that without steroids you will be left with a deficit. That is totally unpredictable. Many of us, including me, have had multiple and long-term attacks of vertigo that have resolved on their own without damage to anything.

Just some things for you to consider.  Good luck,
ess

[daisy.girl]

Personally I would not do the steroids....they only treat the symptom you are having right now, and have no effect at all on the overall progress of MS.  The side effects are just too serious in my opinion.

I know it is a hard decision when you are the one in so much discomfort. Below is information from the multi-sclerosis.org web site.

This is a from the website below:

http://www.mult-sclerosis.org/steroidtreatments.html

"It seems to me that the use of steroids to treat MS relapses is not as contraversial as it should be. While glucocorticoids are certainly effective at reducing the immediate impact of relapses, they have been found to have no effect at all on the overall progress of the disease. I would like to reiterate this: steroid use does nothing at all to delay the progression of multiple sclerosis. Seen this way their use is merely palliative much as taking an aspirin to treat a headache reduces the pain but does nothing to address the cause. This would be fine if steroids didn't have such significant side-effects.

Since so many of the cells in the human body have receptors for glucocorticosteroids, it's not surprising that they have such a range of side-effects. These can (but by no means always) include: acne, weight-gain, seizures, psychosis, depression, headaches, fatigue, facial hair, nausea, vomitting, adrenal insufficency and many more some of which can be very serious. Long-term use of glucocorticoids is not advised nor is it effective in MS.

Potential severe side-effects are part and parcel of all drug use and we all have to make a decision on whether the benefits of a particular drug outweigh it's disadvantages. I tend to be rather conservative - as far as disease progression goes, I like the idea of drugs that slow down the rate of progression but I'm also not adverse to taking a drug that mitigates against severe symptoms. As far as glucocorticosteroids are concerned, I would need the relapse to be pretty severe to consider their use. Relapses tend to remit within four to six weeks and steroids don't affect the amount nor severity of the residual deficits. You have to make up you're own mind with your own neurologist to advise you."

Best of Luck on your decision.

[meg321]

Hi Jess,

Hope this helps, I had a vertigo attack which started all of this, I couldnt stand or move without throwing up so i ended up in ER..they sent me home with the wrong diagnosis, I will keep a long story short, but nothing was done to help me.

To this day, and it started 7 yrs ago now, I am still dizzy and my balance has always been bad, although my balance may be better.

I dont know much about taking the steroids but someone else can most likely help you with that.

Would like to hear what you decide.

hugs, meg

[jensequitur]

IV steroids (afaik) are better for you than the oral steroids.  They've shown that symptoms have less of a chance of coming back if you take oral steroids.  

The main problem with them is that they can cause you to gain weight.  I was on oral steroids for a month, and it definitely threw my metabolism out of whack.