On 26Apr2013 (Friday) during traveling back to Mumbai from my native place at Konkan, I had headache & vomiting feeling due to bus motions. (The bus was AC multi-axle Volvo). To avoid vomiting I tried to slept on either right or left tilting neck either side. Morning when i reached home had light headache. After that i took my bike to drop my. When I kick to start my bike at that point I had fainting issue and told my wife i am fainting little bit. After driving home it turned in to severe headache and I went to sleep.
In afternoon I was fine I replied to office mails from my laptop and went to sleep. In the evening while waking up from bed had first episode of spinning. Then in the night when I bend my neck to wash my hands, I had second fainting/spinning episode. Every spinning episode I thought was due to 11hrs traveling effect from Goa to Mumbai.
Next day Saturday (27Apr2013) morning, I took my wife to see my family General Physician (GP) as she (my wife) had vomiting problem. I took my car 7 when stepping down out of car I got spinning effect. Somehow managed with taking support of my wife to reached GP dispensary. When I sat down on wooden chair it spinned again and I lost my balance. At that point my family GP diagnosed vertigo and gave 3 days Vertuzac medication and ORS. After returning home had one more similar episode as I drive the car again. I took that Vertuzac till Monday morning after which vertigo precipitated and in evening was moved to ENT specialty hospital through ambulance.
Mean time let me explain suspected reason for vertigo precipitation. Since symptoms were closely resembling BPPV I just tried one set of Epley (home Epley not office Epley procedure) on Sunday (28Apr2013) afternoon. You won’t believe after that I was not having single symptoms after that Home Epley procedure. I was feeling free (no headache, no heaviness or spinning feeling). So in late afternoon I worked on my laptop did office work. In night did shaving and was dreaming of going to office on Monday (29Apr2013) and missed just one dose of Vertuzac i.e. Sunday night. Night time I mistakenly rolled my neck during sleep. Monday morning had slight headache so instead of following home Epley I just tried simple Brandt Daroff exercise which is a home method. After just one set it spontaneously triggered vertigo symptoms immediately after following that procedure. Then i continued usual prescribed dose of Vertuzac but it didn't work. Then I called local GP who visited my home. He saw me and prescribe Stugeron but it also didn't work. So finally evening moved to ENT specialty. The symptoms were so worse even I moved my neck on bed it was triggering spinning. I had continuous headache and heaviness throughout Monday (29Apr2013).
In evening at ENT specialist (29Apr2013) he checked nystagmus which he noted as negative. He did fork tuning test as the machine of PTA cannot be moved to patient ward. (I was asked to sleep in patient ward as I was unable to sit). He Gave Stematil, Rantac & Vorevan IM and prescribed BetaVertin, Stematil and further asked me to take MRI (Brain & Cervical) and spine X-ray. He was suspecting left ear infection but he told me that he is not sure about same. After showing him MRI & Spine ENT on 30Apr2013, he refers me to orthopedic surgeon.
MRI of brain was normal. MRI of cervical showed Straightened cervical spine & desiccation of all intervertebral discs.
X-ray of Spine showed Straightened cervical spine & anterior peridiscal osteophytes.
On 02May2013, I took appointment and visited that orthopedic surgeon. He asked me to do some neck & hand movements but didn't had any pain so he ruled out cervical involvement. He prescribed Vertin 16mg, cyclospasmol three times daily and multivitamins once daily for 5days. My next follow-up was on 07May2013. I used to have temperature and sweating on these medications. During this course from 04May2013, I started sneezing and had sinus pain just above eyes and in right Maxilla. Sunday I got fever 101fernite. I took hot water steam vapor and Vicks action 500, it controlled sinus. I also had runny nose on Sunday (05May2013). By Monday had little sinus pain took one more Vicks Action 500 and sinus went away. In between had pain near neck & shoulder (Just below neck. I usually have intermittent this type of neck pain and Low back pain which are on & off. They come 7 go on their own after taking rest)
By Sunday (05May2013) pure vertigo symptoms vanished but had mild symptoms which includes as follows
1. Disequilibrium (slight off balance after walking around 10steps & heaviness while walking).
2. Other symptoms which includes
a) I feel mild headache and heaviness when I climb down and climb up staircase.
b) I feel mild headache and heaviness when I brush my teeth & comb my hair.
c) I feel mild heaviness when I move my head extreme up or bend myself forward.
d) While reading news paper, I feel strain in my eyes
During orthopedic follow-up (07may2013), I told him about sinus and neck pain and told above mild symptoms. He again asked me do neck & hand movements but didn’t had any pain at that point. So he told vertigo symptoms will subsides slowly. He reduce dose of Vertin 16mg and cyclospasmol to two times daily. But I asked him how long it will take he told me it will take time but if you want to take one more opinion you can seek of Neurosurgeon or ENT specialist.
So on 09May2013, the mild symptoms describe above were not subsiding so decided to visit one more ENT specialist. Told her history showed her MRI & Spine reports. She took my PTA (Pure tone Audiometric) Test which showed Mild conductive hearing loss in left ear (500Hz & 1KHz). Right ear findings were normal. She told symptoms will go slowly noted nystagmus positive. She prescribed Vertin 8mg (3times daily) dose reduced for 05 days and added Meclizine three times daily. She also prescribes Cinnarizine & Antibiotic Toxim-O two times daily for 05 days and nasal drops.she also told me to do eye movement, neck movement exercise. I have completed the five days course and exercise
On 14May2013, now don’t feel mild heaviness when I move my head extreme up but I still have some of mild symptoms describe above plus got one new symptom. Now if I turn my neck to right and tilt it in specific it triggers spinning symptoms spontaneously. Even while walking if I tilt my neck on right side and tilt little bit it triggers spinning symptoms. If I move on left it won’t trigger.
My Recent Medical History
a) I had long standing cough (1-1&1/2 month duration) in 2012 & 2011.
b) Had low back pain and neck pain (In between shoulder and neck and just below neck usually on right). This pain comes and go when I take rest.Have this pain some time monthly or in 15 days.
1. Had taken ORS and plenty of water during initial period of vertigo i.e. from 26Apr2013 to 05May2013). Now I drink enough water.
2. From last week around (05May2013)I noticed that I can move my neck freely on left side i.e. free 90° rotation but I can’t complete the 90° rotation on right side. Maximum I can turn my neck around 85-88° right. If I still try to move I get headache.
Not understanding what to do. When these mild symptoms describe above will go?
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