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Had a vertigo, ear discomfort, dizziness. Cannot drive or kneel. What is going on?

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ENT Specialist
Practicing since : 2001
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My height is 5 feet 8 inches, about 70 kg weight, 41 years of age, male, the last one year I have been suffering great discomfort especially after driving / reversing my car....Doctors checked my random blood sugar levels and ECG and said both normal.....General physician & ENT said it was vertigo....during that time I had some ear discomfort also and could not tolerate loud sounds and usage of mobile phones.....I took vertin 8 mg & 16 mg courses.....stemetil....and recently stugeron - vertin......after stugeron I got relief.....I never had spinning I am much better but there is some discomfort with neck - shoulder area.....I abruptly quit smoking a year ago....I have stopped driving a car......earlier if I would kneel / sit down on the floor and get up abruptly my head would feel a little dizzy The last one year I have suffered...I had balance issues also.....I used to be very hungry if I would delay in having my lunch or dinner as if my blood sugar levels had gone down .....would carry sugar with me while travelling.....bus, train & air journeys became frightful.....I am much better now but still not my earlier normal self...I do some vertigo exercises which help a little bit.....what do I need to do to regain my old a not able to exert myself much now though a lot better.....Pure tone audiometry test was advised but I have not got it done till now? Can you rule out any neurological / brain issue? Is this BPPV / Labyrinthitis / Meniere's disease? What should be my next steps to systematically investigate this? Can I afford to ignore this and carry on with life? Please advise Doctor! many thanks
Posted Fri, 20 Apr 2012 in Ear, Nose and Throat Problems
Answered by Dr. Naveen Kumar 10 hours later

Thanks for the query.

Dizziness also known as lightheadedness is a sense of imbalance and you do not feel as though you or your surroundings are moving. Whereas Vertigo is a feeling as if you or your surroundings are moving when there is no actual movement (spinning, whirling, falling or tilting).

Dizziness could be due to non-specific causes such as hypotension, dehydration, cervical spondylosis, hyperventilation, allergies, etc.

Vertigo could be due to specific causes such as inner ear pathology (benign paroxysmal positional vertigo -BPPV, Ménière's disease, vestibular neuritis, or labyrinthitis), head injury, migraine, vertebrobasilar insufficiency (decreased blood flow to the base of the brain, brain tumors, stroke or transient ischemic attack -TIA), etc.

In BPPV, there will be severe, brief (< 1 min) spinning triggered by moving head in a specific direction.

Meniere's disease is characterized by recurrent episodes of unilateral tinnitus (unpleasant noise in the ear), hearing loss and ear fullness; in this condition there is progressive deterioration of the hearing.

Vestibular neuronitis is usually thought to be caused secondary to viral infection. There is sudden, incapacitating, severe vertigo with no hearing loss and it lasts up to 1 week, with gradual lessening of symptoms.

Labyrinthitis is the inflammation of the labyrinth which is due to either viral or bacterial infection and is associated with hearing loss and tinnitus.

So I do not see any of the symptoms mentioned by you fitting into any of these above conditions. Hence this could be more of cervical vertigo because of the spondylotic changes.

I would suggest you to consult a neurologist as well as an orthopedician rather than an ENT specialist for a complete evaluation and management. Till then continue with present medication and the vestibular rehabilitation exercises (physiotherapy for vertigo).

Hope I have answered your query; I will be available for the follow-up queries.

Dr. Naveen Kumar N
ENT and Head & Neck Surgeon
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