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Dr. Andrew Rynne

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Doppler test showed beginning stage of vascular headache with imbalance problems. Are prescribed medicine safe?

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Dr. A.K. Srivastava

ENT Specialist

Practicing since :1984

Answered : 1975 Questions

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Posted on Sat, 9 Feb 2013 in Ear, Nose and Throat Problems
Question: Dear doctor,

Last week, I had imbalance problem with mild giddiness. I already have sinus problem and I am taking nasal sprays (fluticone). My neuro specialist ordered MRI brain , mra angiogram and venogram, complete blood test (includes kidney, liver, urine, sugar and lipid profile ), vestibular test ( vemp and beer test ) and a trans cranial Doppler effect test . All the reports came normal except the Doppler test suggested that I have a sub optimal temporal window on my left side of my ear. and my neuro specilists referred me to ent specialists . My ent specialists reviewed those results and told me that I am in the beginning stage of vascular headache with imbalance problems. My ent specialists suggested me the following medications 1. Vertin 16 mg (in case I develop dizziness), 2. Absolut 3g capsules (1-0-0) 3. Neuromet (1-0-0) 4. Sibilieum 5mg (0-0-1)

Kindly let me know the following:
1. Whether the diagonsis is correct
2. Whether I am in the right medication
3. Is a sub optimal blood flow in my left ear is a vestibular disease?
In additiion to above, i told my ENT specialists that i get pain in my left eye, left ear, right eye and right eye when i bend down of lift heavy objects. she told me that sibilieum is used both for migrain and vestibular disorders. Please kindly advise

doctor
Answered by Dr. A.K. Srivastava 1 hour later
Hi,

Thanks for the query.

I have diligently gone through the details you have given. You had giddiness from last one week. May I know some more details to guide you better?

1. Whether the giddiness is steady or fluctuating during last seven days time?
2. Is there any variation in the morning or evening hours?
3. Is there any factors which aggravated the symptoms?

I would recommend to please go for E.N.G.(Electronsytagmogram) test. This will confirm whether you are having vestibular disorder or not.

As far as your queries are concerned,

1. The diagnosis seems to be correct unless the report of E.N.G. changes it.
2. With the information that you have provided, the medication appears to be correct. Final decision would be subjected to the report of E.N.G.
3. Sub optimal blood flow to vestibule of ear is a vestibular disease.

Hope I have answered your queries. Let me know the details, so that I can guide you better.

Regards
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. A.K. Srivastava 55 minutes later
Dear doctor

Thanks for the reply. Please find below my responses to your queries raised

I had only mild dizziness. It comes whenever there was a imbalance.

Dizziness mostly occur in the morning. The dizziness occurred when I went for a work out in a gym.

My blood pressure levels are normal too. My ent specialist suggested that I don't require an eng test since she said it is not that much relevanj now since all my other vestibular tests like position test. Audiogram. Vemp . BERP and EEG test have come out normal

Kindly advise
doctor
Answered by Dr. A.K. Srivastava 4 hours later
Hello again

The information provided by you regarding your problem....as your dizziness is mild such type of mild dizziness due to vestibular dysfunction are transient and recover well in 2-3 weeks time, by spontaneous vestibular rehabilitation.

During this period only supportive & symptomatic treatment with medicines is required as provided by your E.N.T. doctor.

Just be relax in due course of time you would recover well.

Wish you speedy recovery.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. A.K. Srivastava 10 hours later
Dear doctor,

Many thanks for the reply.

I have only one query to ask. My Doppler effect test says that I have vestibular disease, but my ent specialisats has given me sibilieum. I understand that sibilieum is only a migraine medicine. My doubt is whether sibilieum also cure vestibular disease?

If so what are the side effects of sibilieum? I found in internet that betahistine is the best medicine that cures vestibular disease. My ent specialists also says that I can take vertin only if I have dizziness.

I am really confused . Please help me. Am I on the right medication?
doctor
Answered by Dr. A.K. Srivastava 1 hour later
Hello,

I have reviewed all your concerns. In addition, I would like to tell you that migraine is a disease of unknown etiology. The only finding, which we see is subnormal blood flow in vessels of half side of head.

On the other hand subnormal blood flow to vestibule as in your case is now demanding increase in local circulation thus choice of medicine will be similar.

Please do not bother about side effects of sibelium, for your kind information I would like to tell you every medicine has side effect and side effects usually occur after prolonged use of medicine by self-medication.

Since you are in the supervision, so forget about side effect. Thanks.
Above answer was peer-reviewed by : Dr. Shanthi.E
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