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Dizziness, Frontal Lobe Epilepsy. Epley Maneuver Tried. Brain CT Scan Normal. History Of Vertigo. Treatment For Symptoms?

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Posted on Sun, 24 Jun 2012
Question: I have been dizzy now for 3 weeks today, at first i thought it was a vertigo attack as i do suffer with those occasionally. Normally they will last for 3-4 days not weeks, i also have a constant burning smell that has been off and on for 2 weeks. I have been to my GP and he is scratching his head, he tried me or serc and that did nothing, as well as meds for vestibular migraine. I have had a brain ct and it's clear. My Dr is now thinking (i think he said frontal lobe epilepsy) and has given me a script for that. I have tried the Epley maneuver and it has made me worse, it feels when i move my head side to side like there is fluid between my ears, nearly like when you have water in your ears without feeling the water slush around if that makes sense
doctor
Answered by Dr. Shiva Kumar R (1 hour later)
Hello,

Thanks for posting your query.

From the information submitted, it is likely that you are suffering from episodic vertigo and constant burning smell (parosmia). The first possibility I would consider is vertigineous or vestibular migraine rather than frontal lobe epilepsy. Another close possibility is benign paroxysmal positional vertigo (BPPV). However, parosmias do not occur in BPPV.

So I personally would like to still consider vestibular migraine. Treatment of vestibular migraine is difficult and this condition usually does not respond to the usual medications of migraine.

BPPV can be confirmed by a small bed side test called as Dix Hallpike test. If positive, the most effective treatment is a procedure called "Epley's maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. Out of the 6 canals in both the ears, if a wrong canal is chosen and Epley's is advised, it can worsen the dizziness.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your vertigo specialist. Till then you stop "Epley's maneuver, and continue medications for migraine.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Shiva Kumar R (6 hours later)
Thank you for your response, would be normal for the dizziness to last as long as it has, in 3 days it will be 4 weeks, i do not a have a vertigo specialist only my GP, should i ask him for a referral to a specialist, would it be a Neurologist? After being on medication for Vestibular migraine and the treatment not working my GP suggested i stop, you are suggesting i start it up again. Due to it becoming worse again since the Epley Maneuver i have started Stemetil again, do you recommend this.
doctor
Answered by Dr. Shiva Kumar R (13 hours later)
Hello

Thanks for the query.

If you have stopped your migraine medicines, hold on till you XXXXXXX the Neurologist. For time being you can continue on stemetil for vertigo. Dizziness in vertigineous migraine can last for days and sometimes up to a week. So XXXXXXX your Neurologist to confirm the same.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Shiva Kumar R

Neurologist

Practicing since :2001

Answered : 504 Questions

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Dizziness, Frontal Lobe Epilepsy. Epley Maneuver Tried. Brain CT Scan Normal. History Of Vertigo. Treatment For Symptoms?

Hello,

Thanks for posting your query.

From the information submitted, it is likely that you are suffering from episodic vertigo and constant burning smell (parosmia). The first possibility I would consider is vertigineous or vestibular migraine rather than frontal lobe epilepsy. Another close possibility is benign paroxysmal positional vertigo (BPPV). However, parosmias do not occur in BPPV.

So I personally would like to still consider vestibular migraine. Treatment of vestibular migraine is difficult and this condition usually does not respond to the usual medications of migraine.

BPPV can be confirmed by a small bed side test called as Dix Hallpike test. If positive, the most effective treatment is a procedure called "Epley's maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. Out of the 6 canals in both the ears, if a wrong canal is chosen and Epley's is advised, it can worsen the dizziness.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your vertigo specialist. Till then you stop "Epley's maneuver, and continue medications for migraine.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist