HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Lightheaded, MRI Normal, Ringing Ears, Head Pressure, Difficulty Swallowing, Vision Alteration. Any Advice?

Posted on Sat, 30 Jun 2012

Question: Hello and Greetings,
I came across this website because I have been seeking some resolution to my health issue. I have not been feeling well for the past five months. It all started when I was sitting at my desk after I got home from work and looking at the news on the internet as I usually like to do. It was about 10:00 pm, I noticed myself starting to feel lightheaded, then got up to go to bed and felt like I was going to pass out. I thought I might be having a stroke or heart attack, so I had my wife take me to the ER at the local hospital. They kept me there for 4 days doing blood tests, heart tests, etc. However, I somehow felt like the problem was in my head rather than heart. I'm a 49 year old male and had perfect health up to this point.
They authorized a CT of my head and later an MRI and had three different doctors look at the MRI and said it was normal, I have had a neurological physical exam the result being normal according to the doctor.
The situation is affecting every aspect of my life, work, home, everything. I just want to be back to my normal healthy self. Some of the symptoms I am now experiencing are: 1) Constant and persistent ringing in both ears 24/7 since getting out of the hospital 5 months ago, 2) A overall "wacked out" state being like I am halfway in and halfway out of it, 3) Feeling tired all the time, 4) A feeling of tightness or pressure in the head, like something of a full feeling is the best way I can describe it, 5) An overwhelming feeling that something is wrong and I will not be able to function or keep my job - I'm a engineer at an electric utility company, 6) I have noticed some difficulty in swallowing, not particularly hard but noticably different from before the whole thing started, 7) Some alteration in my vision, something like a disoriented visual perception, bluriness, and altered response to light and color.
All of this has been very disappointing and foriegn to say the least. Honestly, I'm quite worried and do not know what to do, or if I should get prepared to die or be incapacitated for the rest of my life. I used have a very active life doing things like biking, jogging, and hiking in the outdoors around my house. Now the physical issue I'm facing has made it so I do not want to do any of those things. Three doctors have told me it is just depression, but I have never before in my life experienced this type of thing, always been clear-headed and in good health.
I would appreciate any thoughts or advice you might share. Thank you very much,
Kindly, XXXXXXX

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Hi

Thanks for the query and an elaborate history.

This seems to be a very challenging case to the doctors. I doubt any relation to depression. Presuming that you have been examined by a neurologist and all the neurological causes have been ruled out and no cardiac cause, then the other probable cause could be either ear or eye related which requires further evaluation.

Meniere's disease is one of the inner ear conditions which includes symptoms like dizziness followed by ringing sensation in the ear (tinnitus), reduced hearing and sometimes associated with or without vomiting.

Vestibuar neuronitis, also called as labyrinthitis is another condition of the inner ear caused due to irritation and swelling (inflammation) of the inner ear. This is characterized by dizziness, difficulty in focusing, reduced hearing, loss of balance, such as falling toward one side, nausea or vomiting and tinnitus.

As your MRI of the brain is normal, it rules out any tumor or bleed or blood clots in the brain. Even cardiac causes have also been ruled out. And hence, I strongly feel either of the above two conditions could be the most probable cause of your problem.

I would suggest you consult a good ENT Specialist and run through a battery of investigations to look for any inner ear pathology. You will require investigations such as Tympanometry and Pure tone audiometry of the ear (to assess the hearing and compliance of the ear drum), electronystagmography (to look for the severity of the dizziness and the probable cause) and an EEG of the brain.

Also, an opinion from the Eye specialist regarding visual acuity will be very valuable.

Apart from these, you need to consume plenty of water; avoid smoking/alcohol/coffee if any.

I hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Naveen Kumar Nanjasetty (6 hours later)

Dear Dr. XXXXXXX

Thank you for writing and your analysis given limited information and history relating to my case. Yes, I do believe it is a challenge for the doctors to diagnose. In fact, the neurologist who examined me said my symptoms are not uncommon; however, he did not have any suggestions or recommendations as to what I should do.
I have read many different websites where individuals have written about their symptoms, which are similar to mine. These websites are related to stress/anxiety. Could the symtoms I am experiencing be related to stress or anxiety?
As you suggested, I have thought about pursuing further testing but hesitate do anything more than I already have. Nothing against doctors but I do not like going to the doctor. I have had a doctor friend (my neighbor tell me I should not do any more testing). But then think maybe I should since my condition is not getting better.
And then I think maybe it is some disease that will manifest itself as time goes by. Or that I should just get used to it because I might have to live with it for the rest of my life.

Answered by Dr. Naveen Kumar Nanjasetty (10 hours later)

Hi XXXXXXX

Thanks for writing back

I do understand your concern, but, before terming any cause to be of depression, I would suggest you to finish off with the remaining part of the tests. At least, this will give you a piece of mind and will not bother you in future for missing these tests.

If it is related to depression or anxiety, it would have started gradually and would be progressive in nature; it is very unlikely that all the symptoms can start at once. Do not give up, until the actual cause is diagnosed. It is difficult to remain like this for the entire life.

Hope this helps. Let me know if you have any more concerns. And if all your queries have been addressed, please close this discussion.

I wish u good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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. Prasad