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Cervical spondylosis complicating the BPPV. - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   Sir,

I was suffering from vertigo from February 2009 and was continuing Vertin 8 mg thrice daily on advice from Apollo Hospitals, Chennai. I had spinning sensation in head while changing positions in bed. Along with this I have mild cervical spondylosis also. I was quite alright with mild pain in my neck and slight dizziness. But recently, again I felt the spinning sensation in bed and this took place after 8-10 months. I have become quite confused as I am already undergoing Vertin but still that problem reoccured.

Kindly suggest a solution. I am looking deeply for your reply.
Doctor :   hi
Doctor :  
ok
User :   hello sir
Doctor :  
please give me time to read through the history you have typed
User :   ok
Doctor :   i will help you in this
Doctor :  
what measures are you taking for cervical spondylosis?
User :   May I know whom I am talking with?
Doctor :  
as giddyness wil happen with this too apart from the vertigo

User :   Ok madam, I need to talk a neurologist
Doctor :  
ok
Doctor :  
I am a General Practitioner, I believe I can help you within my expertise and If required I shall recommend a specialist.
User :   ok
User :   Ask me
Doctor :  
so please proceed with describing your symptoms in detail
User :   pain in neck,forehead/backhead with giddiness.....
Doctor :  
ok
User :   Say I am reading a newspaper/book then suddenly a sense of dizziness comes
Doctor :  
ok
User :   Initially in February 2009 whenever I used to go to bed,after putting my head down the spinning sensation used to come and would go after some time
Doctor :  
do you feel that you are dizzy with changing your head positions from one position to other no also?
User :   yes..sometimes
Doctor :   ok
Doctor :  
there are various causes that a person has vertigo
Doctor :  
i will explain the causes and symptoms associated with each cause
User :   ok
Doctor :  
such that it helps you better to relate your symptoms
User :   sure doctor
Doctor :  
1. Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction.
Doctor :   This type of vertigo is rarely serious and can be treated with medications and positional exercises.
Doctor :   2. it can also be caused by inflammation within the inner ear (labyrinthitis), which is characterized by the sudden onset of vertigo
Doctor :  
and this infection may be associated with hearing loss.
Doctor :   or tinnitus (hearing ringing sounds in the ear)
Doctor :  
3.Meniere's disease is another cause and is composed of a triad of symptoms: episodes of vertigo, ringing in the ears, and hearing loss.
Doctor :  
this has a abrupt onset
Doctor :  
and fluctuating hearing loss
Doctor :  
here the patient might have gaps of symptom free periods
Doctor :  
have you followed what i have said uptil now?
Doctor :  
are you with me?
User :   yes..definitely
Doctor :  
so shal we proceed with the rest of the causes?
User :   I don't have any hearing loss...I think BPPV is causing problem for me
Doctor :   ok

Doctor :  
i wil tel a few more causes, then we can come to a probable possibility
User :   I had undergone ENG test ...which showed symptoms of BPPV
Doctor :  
Vertigo can be caused by decreased blood flow to the base of the brain. Bleeding into the back of the brain (cerebellar hemorrhage) is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed.
Doctor :   ok
User :   For that I am taking Vertin
Doctor :  
Head trauma and neck injury may also result in vertigo, which usually goes away on its own.
Doctor :  
and cervical spondylosis also causes dizziness in the early/mild stages
Doctor :  
since you are already on vertin
Doctor :  
and not controlled,
Doctor :  
the probability of cervical spondylosis complicating it can be there
Doctor :  
may i ask you when the ENG test was done for you?
User :   let me tell you one thing
Doctor :  
sure Shamik
User :   after using vertin, initially for 6-7 months I did not get vertigo(in bed/or putting my head in a certain direction)...but recently last week I suffered that...now again that is gone
Doctor :  
ok
User :   But the dizziness with neck/head pain is there
Doctor :  
ok
Doctor :  
this also points towards the possibility of cervical spondylosis complicating the BPPV.
Doctor :  
hence i would suggest you to take a orthopedic examination along with a repeat ENT examination
User :   ok...would X-Ray(neck) or MRI(neck) help? And which one I should undergo for?
Doctor :  
yes they will definitely help
Doctor :  
MRI would be better
User :   ok
Doctor :  
as it will give clear picture
Doctor :  
x-ray will only detect bony abnormalities
Doctor :  
MRI wil detect the problems with nerves, soft tissue and disc herniations
Doctor :  
so i would recommend a MRI head and neck for you
User :   Dear doctor tell me one thing...........
Doctor :  
it wil show the brain, inner ear structures and beck structures
Doctor :   yes please proceed with the query
User :   Are MRI-head and MRI-neck are two different tests?
Doctor :  
no, it can be combined into one
Doctor :  
and taken at the same time
Doctor :  
you will not needto do separate MRI's for both
User :   ok...I did undergo MRI-brain in February which was OK
Doctor :  
ok
Doctor :  
did it include the neck structures too?
Doctor :  
if onle brain MRI was ordered, then the neck structures wil not be picturised
Doctor :  
it should be ordered as 'MRI head and neck' then it will include both
User :   definitely MRI-neck was not done
Doctor :  
ok
Doctor :  
did the brain MRI consist of visualizing the inner ear structures?
User :   I am not sure about that.....
Doctor :  
was there anything mentioned in the report for ear related structures?
Doctor :  
are you there?
User :   Not very much sure...but i think it was absent....but the doctor commented seeing the MRI that my sinus was very good...i can remember that
Doctor :  
ok
Doctor :  
MRI brain will show the frontal and ethmoid sinuses
Doctor :   so he would have told that the sinuses were good
Doctor :  
so considering your history and the investigations already done,
Doctor :  
i would recommend you to take a MRI head and neck
Doctor :  
and get a reexamination done for ENT and orthopedics
Doctor :  
MRI will also show the status of your cervical spondylosis
Doctor :  
have you followed what i have said?
User :   yes madam
Doctor :   continue to take Tab. Vertin as prescribed to you
User :   ok....
Doctor :  
and get back to me once you are done with the repeat checks and still any doubts
Doctor :  
Is there any thing else I can help you with?
User :   Dear doctor, where should I undergo and consult the tests?
Doctor :  
you can approach your ENT doctor and request for the tests
User :   As I am in Assam...and not very much confident of the treatement?
User :   May I come down to AIIMS for this?
Doctor :  
he will examine you and may ask for few more tests for the BPPV
Doctor :  
if you are not confident of treatment there, you can consult in calcutta
Doctor :  
Apollo hospital is good
Doctor :   also if you need an appointment with a doctor in your specified area
Doctor :  
we can help you
Doctor :  
you will need to confirm your contact details
Doctor :  
and one of your customer relation team executive will contact you
Doctor :  
are you there?
Doctor :  
have you followed what i have said?
Doctor :   are you there?
Doctor :  
are you there?
Doctor :  
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