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Have Vertigo, MRI Normal, Eye Tracking Off, Noises In Ears, Balance Problems. Could The Symptoms Stem From Inner Ear Disturbance?

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Posted on Fri, 6 Jul 2012
Question: I have suffered with fear of open spaces and fear of falling since I was a little girl. I always had "issues" with excessive wax in my left ear. I am now 43, and my vertigo and balance has been increasingly worse. In 2008, I had a brain MRI and it was normal. I had two balance tests performed which came back saying that the eye tracking part was way off among other things. My latest issue with my ears has these whooshing/whomping sounds and noises seem to be louder than they actually are. Such as someone talking for example, would produce these whooshing type noises like one would get if they were in a nightclub or heard a loud crashing sound. My balance is way off, I walk in stores with a cart to help keep my balance, I need assistance when walking through parking lots, across streets etc.. anywhere that is open.. even a yard. Therapists have told me that they believe it to be a form of agoraphobia, yet I don't think so. Since elementary school??? Could all my symptoms be stemming from an inner ear disturbance or Meniere's Syndrome?? What is better to help with this issue, an ear specialist or a neurologist? Oh and I also take Lisinopril with HCTZ which I was told by a few people can cause a worsening of vertigo/faintness in people. Thanks for listening.
doctor
Answered by Dr. Ashish Mittal (4 hours later)
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     43 year old female
•     Known case of agoraphobia from childhood (anxiety in open spaces)
•     Concern related to dizziness in open spaces and tinnitus

If we see ear related issues: tinnitus may be related to ear problems like wax or Meniere's disease. As your case is already a diagnostic difficulty for your attending specialist, ear specialist opinion will help in that. He need to examine your ear, inner ear and review you MRI findings. Some time diagnosis is difficult even after these efforts.

As your most of tests are normal with abundance of symptoms which is typical picture of patient with agoraphobia. You need to get examined by psychiatrist. I have seen many case, who improved within 1 month of treatment. If not all, your most of the symptoms will improve with treatment. There is no need to visit neurologist in current situation.

You can continue Lisinopril with HCTZ as your vertigo problem started before the initiation of these medicines.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ashish Mittal (1 hour later)
I forgot to mention that I have only been experiencing the weird noises in my ears this week. Its been occurring almost nightly for about 30 mins or less each evening. Then it dissipates. However, I have also been dealing with a head cold and bronchitis this week as well. Maybe that has something to do with the onset of those whooshing sounds????? .... As far as vertigo and balance issues goes, it seems like the older I have gotten, the worse those symptoms. There is also a sense of faintness involved and depersonalization, that may occur during a bad episode of vertigo or balance issue. It was recommended that I attend a sort of physical therapy at the Balance Center which will help train my eyes. These symptoms are so scary to me that I have myself convinced that I must have a brain tumor or aneurysm that is causing my vertigo and balance issues. I received my first brain MRI in 2008 which came back normal, no masses, no tumors etc.. still here we are 4 years later and I find myself begging my doctor to order a follow up MRI to rule it out again. So far, they feel no need to repeat that test since I was suffering from dizziness, vertigo and loss of balance in 2008 and received a normal result from that MRI. Am I just jumping to conclusions that I need another MRI, or do you think I should still pursue that testing? I will tell you that when I look up in the sky for example, I have to be grounded. That is that certain positions of my head like looking into the air, will make me experience vertigo. This is something that plagued me throughout my life. When I was in school, I couldnt play softball or other games in the field because it requires looking up to catch a ball. That left me feeling faint, dizzy and the vertigo would be unbearable. I have avoided places like beaches, football games, walking through a field, etc .. in my mind not out of fear, but from the unpleasant worsening of my vertigo and balance symptoms. Does this sound more like an inner ear issue? or an eye tracking issue? I have had a recent eye exam which came back fine. Thanks for your help, it is very much appreciated.
doctor
Answered by Dr. Ashish Mittal (40 minutes later)
Hello again,

Vertigo usually occur in inner ear problem but you are already on treatment for that. From your description it is clear that you have lots of anxiety and health related worry, even fear for having brain tumor which points toward the presence of anxiety disorder. Anxiety may also lead to dizziness in many cases.

Before any treatment further it is better to seek consultation, first from psychiatrist, so that your anxiety related symptoms and exacerbation of other symptoms because of anxiety will stop occurring, irrespective of diagnosis.

Wish you good health.
Regards,
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1859 Questions

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Have Vertigo, MRI Normal, Eye Tracking Off, Noises In Ears, Balance Problems. Could The Symptoms Stem From Inner Ear Disturbance?

Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     43 year old female
•     Known case of agoraphobia from childhood (anxiety in open spaces)
•     Concern related to dizziness in open spaces and tinnitus

If we see ear related issues: tinnitus may be related to ear problems like wax or Meniere's disease. As your case is already a diagnostic difficulty for your attending specialist, ear specialist opinion will help in that. He need to examine your ear, inner ear and review you MRI findings. Some time diagnosis is difficult even after these efforts.

As your most of tests are normal with abundance of symptoms which is typical picture of patient with agoraphobia. You need to get examined by psychiatrist. I have seen many case, who improved within 1 month of treatment. If not all, your most of the symptoms will improve with treatment. There is no need to visit neurologist in current situation.

You can continue Lisinopril with HCTZ as your vertigo problem started before the initiation of these medicines.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,