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MRI Revealed Increased White Matter In Front Left Lobe. Could This Be Due To Inner Ear Infection?
Question: Hi,
I had a very large concussion (3 months ago) and since have had memory problems and bad vertigo - the original CT from injury found no bleeds and follow up MRI only revealed increased white matter in front left lobe.
As you can see from my medical history I also am Immunocomprimised - so its possible it is inner ear infection, however I have had extensive IV antibiotics and it has not changed. It is worse when I stand up or lie down backwards, however it has happened when I have turned my head to look at things.
I cant have another CT as I have had too much radiation exposure - do you have any suggestions?
Brief Answer:
Your symptoms are suggestive of BPPV.
Detailed Answer:
Hi,
Thank you for posting your query.
Based on your symptoms, it seems to be BPPV- benign paroxysmal positional vertigo. In this condition, the vertigo (dizziness or giddiness) symptoms are exacerbated by head and neck movements such as turning in bed, or getting up from lying down position, or bending forwards to pick up something. The symptoms occur for short duration and then subside, only to come back later. It may occur several times per day.
The cause of BPPV is related to ear, where there is problem in semicircular canals. There are certain bedside tests, which can show which semicircular canal is more defective.
Treatment is with medications such as betahistine and piracetam.
Vestibular rehabilitation exercises are also useful.
In some cases, bedside manoeuvres such as Epley's manoeuvre can help.
Therefore before we plan for another radiological test (CT/MRI), I would suggest you to consult an ENT surgeon and discuss with your problem. I am sure they will have better treatment similar to the ones I mentioned above.
I hope it helps. Please get back if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad, India
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Prasad
Thanks,
I saw my local GP - the concussion was quite some months ago now, so it is not resolving on its own - my GP made me sit on the bed and lie down sideways - which made my head spin terribly - he could see my eyes flickering, it ws not so bad on the other side - he said that it was an inner ear issue and told me to do that excercise many times a day - sit on bed, lie down to the right and look at the cieling, then sit up and look straight ahead - i did this but it did not help at all. As you may see from my notes - I also suffer from CVID and he said that it could also be an infection as I am succeptable to this kind of infection due to low IgG - but it happened after the concussion - so will they be able to fix this, as currently I dont feel comfortable driving a car and it has been about 4 months now
Brief Answer:
Thank you for getting back.
Detailed Answer:
Thank you for providing more details and clarifications.
It is possible that you have an infection, due to your immunocompromised status. I am sure they would be able to fix this.
It is taking longer due to the combined effects of concussion, inner ear problem and a possible infection.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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