Brief Answer: All explained by Labyrinthitis, No lupus/other Detailed Answer: Hello Dear XXXXX! I can recall our conversation a week ago when you were worried about your Lupus cerebritis and i managed to reassure you that its not lupus cerebritis yet and made you care for your vital organs to control lupus. Now i see you developed vertigo and dizzines and as per your doctors saying that you have labyrinthitis and inner ear trouble leading to these troubles. I want to reassure you its because of it and not lupus cerebritis or some brain tumor or MS. So wait for 4 to 6 weeks and continue the medications as all your results have come clear and this issue will resolve by itself.Give it some time. All you need is some vestibular suppressants for symptomatic treatment.which you are already taking in guise of meclizine.Take 25-100 mg/day orally in single daily dose or divided 6-12 hourly dose. It is continued as long as symptoms of vertigo prevail. Then use is as per needs not daily regimens. I urge you to discuss with your doctor to tailor the dose as per your need. If you have any of these symptoms appearing mentioned below stop the drug. Drowsiness Thickening of bronchial secretions Acute glaucoma attack Blurred vision (rare) Constipation Headache Dry mouth Urinary retention If the above medine is not enough You may ask your doctor about cinnarazine and/or Betahistine like medicines for immediate relief. some antiviral medication, and some antiemetic medications. I suggest salt restriction and diuretic group of medicines to avoid complications though. for vertigo there are some other options which you may consider from like antihistamines, benzodiazepines, phenothiazines, monoaminergic agents, and anticholinergic agents which you can choose from for your relief once consulted by your doctors to pick from. Now Twitching.(Mykomia) Well here is a tricky part abit. Twitching is associated with labyrinthitis too as Eyelid muscles supplying nerves ( Cranial Nerve 7) that is facial nerve and The nerve or hearing and balance (Cranial 8 vestublo cocchlear) are neighbours in the brainstem and arise from same location and the facial nerve also passess through ear labyrinthine apparatus too so that all explains your twitching and its synchronisation with your vertigo episode too. Any how twitching is benign and self limited and there is nothing to worry about. So in nut shell your eyelid twitching and vertigo are both because of labyrinthine apparatus infection( labyrinthitis) as your doctor said and you need nothing to worry about. But if it bothers you you can avoid Excessive caffeine and possibly alcohol and excessive physical exertion and activity and all stimulants to relieve symptoms. And if the problem still persists you can consult an opthalmologist for Topical local subcutaneous botulinum toxin A (BOTOX®) injections of 2.5-5 units each to the affected eyelid region, it wil provide relief for 12-18 weeks And a good opthalmologist expertise will avoid complications like ptosis or lid drooping etc other wise all you need is to stop worrying and wait for it to self resolve. And last but not the least stop worrying about your lupus involving your brain.i told you in earlier discussions too that lups cerebritis presentation is different.There are mental status changes, seizure, stroke, peripheral neuropathies severe cranial nerve involvements,spinal cord involvement, myopathies, and alot more pandoras boxes which open and they themselves say that yes lupus it is. Cheers and chill up. You are not in trouble. Just get some rest and continue antivert with precautionary measures and stay in touch. You are as good as humanly possible. I hope we had a fruitful talk. If you need me for anything more please feel free to ask. Other wise it would be nice of you to close the discussion and rate the answer as per your experience XXXXXXX It was pleasure talking to you again I wish you very good luck and take some special care of yourself. Regards Dr S Khan

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Brief Answer: Plaquenil can but didn't in yours so don't stop Detailed Answer: Hello again XXXXX! You are right. Plaquenil is a life saver for Lupus patients. And you doctor is right too about plaquenil's resulting in vertigo. But your vertigo is not because of this. Because a vertigo of 2 weeks can't be from an agent you are using from 8 months. Odds decrease very much. And no don't stop or reduce the plaquenil dose. 200 mg is the maintenance dose and should not be reduced further. But you can change the time of its intake. Take it in the dinner timings with food or milk and I am sure it won't be your vertigo agent any more. Have an eye on your Complete Blood Count and regular eye examinations to avoid it's complications. Continue the Vertigo treatment and don't stop plaquenil. Worsening lupus for a simple vertigo is not worth it. And do take an opinion from your rheumotologist and i am sure he will say exactly as i told you. Stay in touch Hope I was of help. If you have no further queries you know what to do :) Cheers & Regards Dr S Khan

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