The Medical Consumer's Advocate
Oscillopsia
The floor is going up and down...
Q:
Five years ago, I was
diagnosed with hypothyroidism. I get a TSH test
done regularly in order to ensure I am taking the
correct dosage of Synthroid.
However, every few months or so, dizziness will just
come on suddenly. It is not a 'spinning around' dizziness
but more like I am standing still and the floor is going
up and down (sort of a 'vertical' type of motion although
I am perfectly still). Walking up or down stairs poses
somewhat of a problem during this time. Most recently I
felt this way at night. When I woke up the next morning,
even before opening my eyes, I knew I was going to feel
the dizziness which I did. I simply opened my eyes (my
head still lying flat on the pillow) and I was dizzy. It
will go away after about 10 minutes but then reappear
during the day a few times. This will last for about 3 or
4 days and then will disappear completely for the next
few months. I spoke to my G.P. about this who has only
said, "There is nothing I can do. There is no blood
test for this." I had mentioned this to him a few
times!
From what I can recall, I feel somewhat fatigued when
these spells occur. And, perhaps I am eating more
carbohydrates than usual, but I don't really think that
such would affect this. My eating habits do not change
too radically from one day to the next....
I would love to know if there is a certain food group
that I should be avoiding (i.e. carbos, more protein,
etc.) or what in fact is really going on! This does
concern me. I haven't been happy with my doctor's
response to this.
Any comments or insight, Dr. Hoffman?
A: Regarding your question, first of all, I
would like to take this opportunity to respond to your GP's
comment, "There is nothing I can do. There is no blood
test for this."
PHBBBBBT!
He can refer you to an ENT, if
nothing else! Jeez, that is the lamest comment I have heard
in a long while.
The character of your dizziness is
reminiscent of a symptom called "oscillopsia."
(Aw-sill-ops-ee-uh.) Typically, people with oscillopsia
notice that their visual field pops up and down as they walk
or climb stairs. But does this up-and-down sensation happen
even when you are lying still? If so, then it is not
oscillopsia. This link at
VEDA, the Vestibular Disorders Association, provides an excellent
discussion of oscillopsia.
I do not know of any dietary links
to dizziness, except perhaps hypoglycemia (low blood sugar). Most of the
time, people who say they are hypoglycemic are experience
lightheadedness, not the bouncing sensation that you
describe.
If your thyroid hormone levels have
been checked and are within the normal range, then there is
probably no link between your hypothyroidism and your
dizziness.
So I jeered your GP but,
ultimately, I do not have any bright ideas (other than the
fact that you need an ENT!) I am assuming you saw the essay
on dizziness at:
One of the reasons that I can't
give you any great ideas is that the diagnosis of dizziness
is fairly difficult. It is not unusual for me to spend 30
minutes, sometimes even more, talking to someone and
examining them. And even then, there are some folks that I
just can't figure out. What I am trying to say is, your ENT
will need all of the facts (your entire medical history, as
well as the history specific to your dizziness) to have any
chance of putting this together. My advice is that you go to
your appointment as well-organized as possible. Some ENTs
dread dizzy patients, simply because it takes a long time
to do a proper job of taking a history and performing an
appropriate physical exam. Try to get a referral to an ENT
with a good reputation. If you really get frustrated, you may
need to seek out an otologist (ear specialist) at your
closest medical school.
Hope this helps; let me know how it
goes.