What causes vertigo?
User rating for this question
Had vertigo spell in nov.. And still feel off balanced.. All my tests were normal.. Not an inner ear issue. What else can this be.. No spinning just feel like evrything seems like its moving when I walk and when I sit i feel like I am rocking.. MRI and mra all normal... Hearing tests all normal.. Sent me to neuro but what is left for them to test me for
Posted Fri, 28 Feb 2014 in Ear, Nose and Throat Problems
Answered by Dr. Sriram Nathan 2 hours later
Brief Answer: be patient Detailed Answer: Hello and welcome to health care magic, I am Dr Sriram Nathan an ENT surgeon who has been exposed to thousands of patients with vertigo and have a fair amount of success in treating them. Now there are some things and check list which you must understand so that you can be assured. Let me put it in points so that you can get it more clearly: -Vertigo is like headache which can have many many causes and in most of the cases we cannot frankly tell you the exact cause. The test which we do are only to reassure you and us that the cause is not something sinister like a tumour for example. Most of the tests in vertigo are just indirect pointers to the cause and none of them are definite. -In spite of this we need to do these tests so that we do not miss the obvious and the sinister as I explained above. -I am assuming that you have done most of the tests. In any case the routine test battery of vertigo should have audiometry, balance testing, electronystagmography, CT Brain and CT temporal bones and VEMP. I do hope you have done these tests as a priority and I am assuming that these were normal. If not get them done and share the results with me. -Now assuming that all these test were normal we know that you have a balance problem that is better now but not completely relieved. You must realize that any balance problem will recover if sufficient time is given. Our brain has tremendous capacity of recovery and adaptation and if you give support to the brain as I will explain below you can recover. -The supportive measures include these: 1. Avoid any sudden movements including when you get up from the bed 2. Do not enter or go into a dark place or room 3. Google for vestibular rehabilitation exercise and do them regularly 4. While climbing stairs do hold the side railings for support 5. Reduce your mental stress and try relaxation techniques like yoga or meditation 6. Be active but slow and steady which will exercise your brain like a muscle and help the recovery 7. Do not take prolonged bed rest as it will impair the recovery -You must also continue anti vertigo medications like betahistine in consultation with your doctor and gradually reduce the dose of the same. -Finally a neurologist can help you out in terms of ruling out any major cause of headache and also examine whether your nervous systems are fine which will definitely help in your recovery. So do go ahead with the consultation Just remember that it is only a matter of time and you will definitely recover. Hope this helps and if you have any other doubts I will be only happy to help regards Dr Sriram Nathan
Follow-up: What causes vertigo? 21 minutes later
I had all the test done except for ct scan... All normal.. It feels like the back if my head moves when the off balance happens.. It's been 3 months!!!!Also I went to vestibular therapy and did one consultation and she said I don't have vestibular neuritis!'
Answered by Dr. Sriram Nathan 15 minutes later
Brief Answer: give some time Detailed Answer: Hello again, You must understand that vertigo treatment and recovery can sometimes take years and three months is in fact very less. Not that it will take so long for you as it depends from person to person and on the effort in terms of vestibular rehabilitation and also on the adaptation of the brain. A reduction and control of mental stress also helps the recovery Vestibular therapy is not only for vestibular neuronitis, which is an infective and acute condition. These measures are for any giddiness like I mentioned earlier to give mental exercise to the brain for active recovery and good balance. You need to give some more time and follow the measures which I have suggested earlier religiously for some time and then asses the outcome. Hope this helps regards Dr Sriram Nathan
Follow-up: What causes vertigo? 20 minutes later
Answered by Dr. Sriram Nathan 40 minutes later
Brief Answer: relax Detailed Answer: hello again, I have gone through your report and it has not much significance to your present condition. In any case you can have the neurology consultation and he will be able to help you out better with that investigation. Your ENT doctor would have meant that you may not have giddiness because of inner ear problem as all your tests of the ear may have been normal. But let me tell you by my experience that I can only say that your ear tests are normal but I cannot surely confirm that the giddiness is not due to inner ear as inner ear problems are the most common cause of giddiness even if all the tests are normal. And in any case just like headache there are many contributors of the cause of giddiness and to point out only one organ is not possible. Like I mentioned before, giddiness is a loss of balance between ear, brain and eyes and any of the conditions affecting these can cause imbalance. So to try and find out the cause would in many cases just be a waste of time and money and an exercise in futility. But this is just my experience of treating more than thousand patients with giddiness and the protocol varies from hospital to doctor. Some terminology is to be understood here. Giddiness is any imbalance or balance problem which is also known as vertigo. But in some context a giddiness due to inner ear problem is called vertigo but all these terms are interchangeable. In any case many times what a patient feels cannot be put into words and these terms are only technical. I can understand that you have tremendous stress with two small kids and all and like I mentioned before, mental stress will worsen the giddiness. So you must seek out a relaxation technique and try them so that you will recover. Finally, I would like to reassert that what advice I had given earlier is not something which can be done in a matter of time. You need to give sufficient time which is the norm. You must understand that there is not quick remedy or instant remedy for giddiness and instead of worrying about the cause you must try the methods which I have explained including the rehab exercises which cannot just solve your problems in one session! and the relaxation technique. Please have some patience and give some time and you will definitely get better. Hope this helps regards Dr Sriram Nathan
Follow-up: What causes vertigo? 38 hours later
Do u think acupunture would help this rocking feeling that I am getting? Can this be Parkinson's or ms or something else? In your opinion.
Answered by Dr. Sriram Nathan 8 hours later
Brief Answer: try everything..... Detailed Answer: Hello again, When it comes to treating giddiness, there is no absolute... if you feel that a treatment may work then most of the time the placebo effect is so strong that even acupuncture may work. In any case try with caution and guidance Your neurologist will in fact rule out any causes like MS or Parkinsons... so go ahead with the consult... Hope this helps Regards Dr Sriram Nathan