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Having Dizziness And Loose Consciousness. Had Surgeries For Hip Replacement And Gall-bladder. Guidance?

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Posted on Thu, 18 Jul 2013
Question: Twice in the last six weeks I have fallen over backward when I began to lean forward. I am female, 86. Neither time did I lose consciousness. I have some dizziness most of the time and my balance is not good. A cane is now used. I have a harder time finding words which used to come easily. I have had four surgeries since last august.hip replacement, gall-bladder, hip repair, gall stone removal from billiary duct.This last was followed by pulmonary edema in recovery room.I wonder if I am having ear trouble, too!
doctor
Answered by Dr. Vivek Chail (2 hours later)
Hello XXXXX,
I have read your query with diligence.
You have fallen on two occasions after what you describe as losing balance. In addition, you are feeling dizziness and lost for words.
Coming to the present problems:

1. Loss of balance can occur due to any problem in the brain (the cerebellum and adjacent structures) or in the inner ear (the vestibular system). Of importance to discuss is your surgery for a benign brain tumor way back in 1986. It would be great if you could give me additional details on the tumor you had, its location with surgical treatment and follow-ups. A recurrent appearance of a benign tumor cannot be entirely ruled out without complete investigation by CT scan/ MRI scan brain.

2. I would also keep in mind the normal changes in the brain due to aging when considering your problem in finding words

3. On the other hand, if it is something to do only with your vestibular system, few tests will confirm any abnormality in your inner ear.
A. Electronystagmography (ENG)/ videonystagmography (VNG)
B. Electrocochleography (ECOG)
C. Rotational chair test
D. Posturography

I would surely like this discussion to continue further after getting an update from you regarding your benign brain condition as mentioned above.

Further questions welcome.
Wishing you good health.

Regards,
Dr Vivek




Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Vivek Chail (14 hours later)
The brain tumor was a benign meningioma located in midbrain. The olfactory nerve was involved but only part of it on left side was injured. Since my two falls the most pain is located in my neck which took the brunt on the falls. A chiropracter has helped with adjustments but the pain continues.Does all this involve the cerebellum, etc to the degree it's possibly necessary to get a CT scan or MRI. I have an app't with a neurologist on July 10. I am concerned.
doctor
Answered by Dr. Vivek Chail (9 hours later)
Hello XXXXX,
Thanks for sharing the updated information.

The brain is a very complex structure and even a slight pressure on the vestibulocochlear nerve (nerve of balance) can cause dizziness and a sense of loss of balance.

Keeping this in mind, there are few possibilities to consider in your situation:

1.     It has been almost 27 years since your meningioma surgery and we really cannot rule out a recurrence that could be causing some sort of pressure effect on your cerebellum and adjacent structures or vestibulocochlear nerve at this point in time and a complete clinical examination and imaging investigation (MRI scan Brain) may be necessary.

As you have mentioned, the meningioma was located in the midbrain region and partial involvement of the olfactory nerve on the left side. Literature on meningioma says that there is a rare possibility of recurrence, though the tumor continues to be benign. It is said that recurrence rates increase over time after complete excision.

2.     There could be a slight pressure on the vestibulocochlear nerve (inside the head) due to surrounding blood vessels and that can stimulate the nerve leading to a feeling of dizziness. This can be positional at times.

3.     The possibility of anything wrong in your inner ear persists. If no intracranial cause for your dizziness can be found, you must be investigated for inner ear dysfunction.

I am glad that you are meeting your neurologist on 10 July. Please remember, the above scenarios are only possibilities. Let’s hope the best for you and that there is no serious underlying cause for your dizziness.

The neck pain could be of due to muscle strain and should subside soon.

Further questions are welcome.

If you do not have any questions, I request you to please close this thread and post a feedback.

Wishing you good health.

Regards,
Dr Vivek
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Vivek Chail

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Practicing since :2002

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Having Dizziness And Loose Consciousness. Had Surgeries For Hip Replacement And Gall-bladder. Guidance?

Hello XXXXX,
I have read your query with diligence.
You have fallen on two occasions after what you describe as losing balance. In addition, you are feeling dizziness and lost for words.
Coming to the present problems:

1. Loss of balance can occur due to any problem in the brain (the cerebellum and adjacent structures) or in the inner ear (the vestibular system). Of importance to discuss is your surgery for a benign brain tumor way back in 1986. It would be great if you could give me additional details on the tumor you had, its location with surgical treatment and follow-ups. A recurrent appearance of a benign tumor cannot be entirely ruled out without complete investigation by CT scan/ MRI scan brain.

2. I would also keep in mind the normal changes in the brain due to aging when considering your problem in finding words

3. On the other hand, if it is something to do only with your vestibular system, few tests will confirm any abnormality in your inner ear.
A. Electronystagmography (ENG)/ videonystagmography (VNG)
B. Electrocochleography (ECOG)
C. Rotational chair test
D. Posturography

I would surely like this discussion to continue further after getting an update from you regarding your benign brain condition as mentioned above.

Further questions welcome.
Wishing you good health.

Regards,
Dr Vivek