been having dizziness since 2004..was bad for about 2months couldn't work...had other weird symptoms like tingling numbness...lots of fatigue..have had two mri's..first had some spots second in 2007 more spots...finally after six years have seen specialist for ms..says not ms ..spots just part of aging..said was benign positional vertigo..and doesn't know why i have the other symptoms. He gave me exercises to do..but i don''t feel dizzy when i do them...just feel dizzy in day to day activities...am i supposed to feel dizzy when i do them if i have positional vertigo..or is it something else
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.
I am not sure what you mean by the term dizziness. When some people use the term dizziness, they often mean vertigo, or room-spinning. Others mean a light-headed, whoozy feeling.
If by dizziness you mean vertigo (room-spinning), the causes could be either the inner ear or the brain. Inner ear causes of vertigo most commonly include benign positional vertigo (BPPV), which is due to small particle in the inner ear that moves out of place, and can be repositioned with simple head maneuvers. The symptoms often include vertigo that occurs with turning of the head as you mention, often while turning over in bed. Another cause, if your symptoms are associated with tinnitus (ear ringing) and hearing loss is called Meniere’s disease and can be treated with medications and sometimes surgery. And so on, several other causes from inner ear problems exist.
Vertigo can also be due to problems in the brain. The most common is a benign tumor called a schwanoma (also called acoustic neuroma). This is diagnosed by MRI of the brain, and if your MRI was done with contrast and did not show one, then this is unlikely (also typically, schwanomas cause hearing loss rather than intermittent vertigo). Multiple sclerosis can cause vertigo, but often, other symptoms are present as well; the distribution of the spots on your MRI can help distinguish MS from the spots that occur with aging (what is called small vessel disease). Thyroid problems can also lead to vertigo.
If your vertigo occurs with headaches, your symptoms may be consistent with a variant of migraine called basilar migraine. Basically this is marked by several hours of vertigo associated with nausea, light-sensitivity, and sometimes other symptoms. Headache may or may not be present. The treatment is different from that used to treat other migraine types; the treatment in this case is a type of medication called calcium channel blocker, such as verapamil, which is actually used to treat blood pressure but works in type of basilar migraine as well.
If by dizziness you mean light-headedness, causes could include low blood pressure such as due to dehydration or autonomic dysfunction, cardiac problems, and several other non-neurologic causes. Anemia can cause light-headedness as well.
Continued follow-up with your physicians is recommended. If you have been recommended vestibular rehabilitation, it is important that you do the exercises consistently, as if you have an inner ear problem, these maneuvers can help re-train your inner ears to a new balance, to prevent the dizziness.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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