The Medical Consumer's Advocate
Lingering dizziness
Vestibular neuritis?
Q:
The
week before Christmas, I woke up not feeling quite
right... I went to work anyway but I started to feel
dizzy... I went to my doctor and he diagnosed me as
having labyrinthitis... said it was caused by a viral
infection and that there was nothing he could do... it
continued to get worse and on Christmas eve, I had my
boyfriend take me to the emergency room... the doctor
there said the same thing, only he gave me some valium
which seemed to make me even more dizzy. After the
Holidays, I went back to my GP and complained because not
only was I not feeling any better, my right ear had
started ringing... he again did nothing...
I was so frustrated and
confused about the lack of treatment, I went out to the
-- Clinic in --, and saw an ENT... he performed a series
of balance tests and called my ailment neuritis; again no
treatment; he just told me it can take months to go away.
Obviously, this lack of
treatment did not sit well and again I found myself back
in my GP's office; he finally agreed to send me to an
ENT, who did nothing...
... I was convinced that
something was desperately wrong and I demanded that my
doctor do something... he finally agreed to an MRI which
showed "significant mucosal disease of my sinus
cavities" and nothing else... I saw an otologist who
diagnosed me as having vestibular neuritis and again gave
me nothing... said I could have it for a year!
I researched VN and while some
of my symptoms fit, some did not. I have this pressure in
my head (specifically my ears) constantly, although my
doctors said there is no fluid behind my eardrum; my neck
muscles ache all the time and my right ear has not ever
stopped ringing.
Do you have any suggestions? At
this point, I would even be willing to see someone
outside my HMO - they don't seem to be doing anything
anyway...
One last thing... I am suppose
to get a CT Scan of my sinuses in June... after all this
time...
Sorry I seem a little bitter...
it just has been very frustrating to feel this way for so
long....
Thank you for any information
you can provide.
A: I generally don't like to
diagnose people over the internet. From what you have written, my impression
(or call it a hunch) is that your ENT care has been competent.
So let's just assume that the diagnosis of vestibular
neuronitis (or neuritis) is correct. If so, I would not agree
that there is nothing to do. It is very possible that
"all of the damage has been done," in other words,
you may very well have a stable deficit of your vestibular
system. If this is the case, the answer to your problems is
very straightforward: vestibular rehabilitation!
You can start this
yourself by practicing Cawthorne exercises (follow
link and scroll down the page). Better still, find a therapist (typically a physical
therapist or occupational therapist) who is familiar with
vestibular rehabilitation. If you get too many dumb looks and
"Huh?" replies, then you need to contact your local
medical schools and contact the otolaryngology (ENT)
departments for information on vestibular rehabilitation.
If, however, your illness is not
stable (i.e., if you are sustaining further damage
to your vestibular system), you will have a poor response to
rehab and you will have to wait until your problems stabilize.
But this is unlikely.