Question: I am a 35 year old male suffering from peripheral vestibular lesion with cerebral atrophy. the problem started from the month of May, 2012. I was having irregular heartbeats, severe sweating, getting collapsed while standing, sometimes total blackout, inability to stand for long time which i could earlier, giddiness, nausea, imbalance, tremor in legs while standing. I started visiting doctors around my workplace in Assam. They conducted several tests but the reports came normal. Lastly in the month of Nov,2012 they did a CT scan and the report was Cerebral/ Cerebellar atrophy. The doctor started the treatment in this line. To confirm the atrophy i came down to KOLKATA and visited a neuro hospital. There they conducted an MRI of my brain and denied the previous report of atrophy. the neurologist told that i am having peripheral vestibular disease and reffered me to an ENT . The ENT conducted some tests including ENG which says that i am having severe vestibular lesion in right ear. I was on Vertigon 25 , Paxidep CR 25, Zapiz 0.25 according to the suggestion of the ENT & Neurologists. I continued the medicine upto Feb, 2013. But on Mar,2013 the problem aggravated and i rushed to CMC Vellore and consulted with the doctor of Audio Vestibular Department there. They conducted some ENT tests and reported that my reflex of right ear is absent and i am having SNHL. From then only I am on Vertin 48, Prothiaden 75. While taking all this medicines throughout this period i was not getting cured completely. The problem was still there. I went for follow up check up again to CMC in the month of September, 2013. The doctors conducted ENG test and reported Bilateral Canal Paresis. They conducted an MRI of brain and cervical region and report is like : mild atrophy with ventricular prominence, Left PCA hypoplasty, Plaque at CCA bifurcation. From then i am on VERTIN 48, PROTHIADEN 75, NEUROBION FOURTE, FINATE 160( my triglyceride is 250), STALOPAM PLUS, FOURTTS B, ZYLORIC 100 ( my URIC ACID is 7.2). But my thing is not improving. I am still having extreme fatigue, i feel drowsy throughout the day, i feel very lethargic, i feel depressed, my eye lids become heavy, often i feel nausea, still i have balance problem, I cant walk for a long distance, i feel like i am floating in the air. I am doing yoga and vestibular exercises regularly. My question is are these problems only because of Vestibular Disease ?. Are these symptoms are related to atrophy too ? Is atrophy normal at my age ? What should be my next step for treatment? In this connection i would like to state that i had met with a bike accident in the year 2003 and was unconscious for more than 20 mins. what should be the precautions for cerebral atrophy ?

Thank you doctor for attending my question.My TSH & HAEMOGLOBIN levels are within normal limits. My Vit B12 is 232 & FOLIC ACID is 7. Previously my one ear was affected. Now my both ears are affected. Is the vestibular disease progressing? Now I feel dizzy throughout the day. If I stand in a place some times I intend to fall. It is getting very difficult to walk without a support. Some memory problem is also arising. Nowadays I am getting angry very soon. Feeling urge of urine frequently. While passing urine it takes a long time to get started, and after finishing I feel that there are some more urine in my bladder. Nowadays I am getting scared of travelling alone. In feel like I am swaying back and front. Stammering while speaking is adding embarrassment in office or anywhere for me. I don’t have strength in my hands & legs like before. I feel very weak & tired. I am scared of going to a market place as I feel swaying like a pendulum all the time. It is getting difficult to move my legs while walking as I feel my legs are getting stuck to the ground. Pls clarify.