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Headache, dizziness, hypertension, taken betahistine and robaxin, nausea. Catarrh?

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ENT Specialist
Practicing since : 1991
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Been feeling unwell for about 3 weeks now. Horrible tight headache above eyes which lasted all day one day, feeling run down, tired, pounding in ears, espec right ear. Pressure feeling in neck. Then about 1 and a half weeks ago, started to feel dizzy at points along with other symptoms already mentioned plus nausea especially in the morning and very shaky when dizzy.. GP initially thought it was a neck problems so gave robaxin, but on second visit a week ago, I was getting dizziness and she looked in ears and said I had cattarh in middle ear. She prescribed betahistine but a week later, it is not helping. I am still getting symptoms and the dizziness especially i find upsetting as I feel awful. Can you suggest what I should try next?
Posted Sat, 5 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 6 hours later

Thank you for your query.

You have provided with good information but I would like to know a few more things as this would help me in suggesting you better.

Please answer the following questions:

a. Are you getting true vertigo (spinning of the head and sensation of objects spinning around you) or only unsteadiness?

b. Does your vertigo / dizziness occur on change of head and body position (for example, while lying down or getting up from bed) or does it occur while walking up? Did you wake up suddenly one day with severe dizziness and headache?

c. How long does an episode of vertigo / dizziness last? Does it subside in a few minutes or does it last for many hours?

d. Do you have any hearing loss or fullness in the ears? Does your hearing change with position?

e. Do you hear sounds or ringing sensation (tinnitus) in your ears, especially in your right ear?

f. Do you have any history of ear discharge? Does your GP think that your eardrum is intact?

g. Have you had a PTA (Pure Tone Audiogram) and an Impedance Audiogram (I/A) done anytime?

h. Do you have Hypertension, Sinusitis, eyesight problems or Photophobia?

i. Have you had cervical spine X-rays done?

Middle ear catarrh is a very generalized term indicating Eustachian Tube (which connects the ear to the nose) dysfunction and implying fluid or negative pressures behind the ear drum. I recommend that you get the above tests done, visit an ENT Specialist for detailed ear findings and get a Neurologist's opinion for the headache.

Awaiting your reply.


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Follow-up: Headache, dizziness, hypertension, taken betahistine and robaxin, nausea. Catarrh? 4 hours later
a) Not true vertigo- no spinning. Justs feels like walking on marshmallows, little unsteady.
b)Feel dizzy when walking around or standing. onset of headache/dizziness wasn't sudden. Had been feeling unwell for a few weeks by this point, tired,run down etc.
c) Episodes usually last about 20-30 minutes then subside and I am usually v.tired afterwards
d) Hearing has been okay. No hearing loss. Some noise in ears like fluid moving.
e) Had some ringing one day in right ear but not since
f) No ear discharge. GP has not commented on eardrum being intact or not.
g)No PTA/I/A has been done. H)BP was slightly up two weeks ago so due back to get checked today and none of other problems have been mentioned by GP
Answered by Dr. Sumit Bhatti 3 hours later

Thank you for writing back.

1. The description of your vertigo does not fit acute ear diseases. With no true spinning vertigo, no relation to change of head position, unsteadiness while walking, long spells of unsteadiness and fatigue there is more possibility of a central cause, cervical spondylosis or chronic ear disease. If your ear examination, PTA and an I/A are within normal limits, the ear may not be a major cause of your imbalance.

2. The associated headache suggests a migraine associated dizziness. Your cervical spine x-rays should be done. This is because dizziness may be multi-factorial. A Neurologist's opinion will be required to rule out any central (brain related) cause.

3. High Blood Pressure may also cause the above symptoms. However, dizziness generates immense anxiety and raises Blood Pressure. Successive Blood Pressure readings require to be recorded. These symptoms may even persist for a couple of days after the Blood Pressure returns to normal limits.

4. While the tests are being conducted, you may request your physician to prescribe cinnarizine 25 mg thrice a day as it has both central (brain related) and peripheral (ear related) action against dizziness.

5. At your age, nothing major should be wrong, however, your physicians may have a list of tests such as directly observing for nystagmus, posture and gait tests, co-ordination tests, caloric test, ENG (Electronystagmography), CT/ MRI Scans that you may have to undergo to exclude certain causes of dizziness.

Hope I have answered some of your queries. In case you have any more queries or wish to share your test results, I will be available to review them.

Above answer was peer-reviewed by
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