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Facing balance problems, had ear infection, suspected fluid in ear. Family history of severe spinocerebellar ataxia. What can this be ?

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My dad and uncle both have severe spinocerebellar ataxia. They did not start having symptoms until they were about 50. I am 32 but about 4 weeks ago I started having balance problems and went to urgent care. They said I had an ear infection and gave me antibiotics. The balance problem comes and goes. I went back a week later when it was bad and they said the other ear was infected. So they gave me a medrol dose pack and different antibiotics. I also went to the ENT, who said I had vestibular problems and gave me some exercises to do. He said the outer and middle ears were fine (no infections) but suspected there was fluid in the inner ear part of my right ear. I assumed I just had an ear problem and didn't even think to mention anything about my dad and uncle. It wasn't until this morning that I made the possible connection. Basically, when the problem occurs, my ears feel clogged (like there's tons of pressure in them) and I have disequilibrium. I feel wobbly. I don't know if any of you have any insights into this based on what I'm describing but I'm wondering if I just have a simple inner ear problem or am developing spinocerebellar ataxia.
Again, timeline:
Late Feb: Fine except that exercise makes me feel wobbly.
3/1: Disequilibrium is bad. I got to urgent care doctor. She says I have an ear infection. I start an antibiotic. Symptoms improve but don't go away.
About 7 days later: Disequilibrium is bad. I go back to urgent care doctor. She said the other ear was infected. We tried a new antibiotic and a Medrol pack.
3/15: I saw an ENT doctor. He said the outer and middle portions of my ears seemed fine. Based on my symptoms, he inferred that I had an inner ear problem. Symptoms were minimal at this time and for the next two days.
3/18 (Today): I woke up with lots of pressure in the ears and disequilibrium. It's been bad all day.
Posted Tue, 22 May 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 6 hours later

Thanks for the query

Your question is a very good one and I will work on providing you with some good information and recommendations regarding what is going on.

From the information submitted it looks to me like you are suffering from episodic vertigo, probably Benign paroxysmal positional vertigo. Spinocerebellar ataxia's (SCA) are characterized by slowly progressive incoordination of Gait along with poor coordination of hands, speech, and eye movements.

Benign positional vertigo is due to a disturbance within the inner ear. BPPV develops when a small piece of bone-like calcium breaks free and floats within the tube of the inner ear. This sends the brain confusing messages about your body's position.

To diagnose benign positional vertigo, perform a simple bed side test called the Dix-Hallpike maneuver. If positive, most effective treatment is a bedside procedure called "Epley's maneuver," which can move the small piece of bone-like calcium that is floating inside your inner ear. A prior head injury (even a slight bump to the head) or an inner ear infection called labyrinthitis may make some people more likely to develop the condition.

So I personally feel you are suffering from benign paroxysmal positional vertigo secondary to labyrinthitis and not from SCA. I personally request you to see a Neurologist for a careful neurological exam to exclude other causes of vertigo.

I thank you again for submitting your question. I hope you found my response to be helpful and informative. If you have any additional concerns I would be happy to address them.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist
Above answer was peer-reviewed by
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