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Question: I am 66 years of age with slight issue of vertigo. This does not cause a restrictions in any of my activities. Initially thought it was an inner ear problem. However, ENT decided to have a MRI performed. The results are as follows:
-Unremarkable MRI of the internal auditory canals
-Minimal periventricular white matter changes
-Unremarkable MRI of the internal auditory canals
-Minimal periventricular white matter changes
Brief Answer:
Inner ear as cause for vertigo unlikey
Detailed Answer:
Hi. Thank you for writing to HCM.
It is common to have some complaints of dizziness or occasional episodes of vertigo at your age. This is related more to the ageing of the body and delay in visual and auditory reflexes. The more common causes of vertigo at your age is probably postural hypotension ( if the dizziness is triggered when standing up from a sitting position) or BPPV - Benign Paroxysmal Positional Vertigo (if dizziness occurs when you are lying down and changing postures).
Since your MRI is normal( Minimal periventricular white matter changes seem consistent with age) there is no obvious neurological cause.
To rule out an inner ear disease completely you need the following tests
1. Dix Hallpike test (To rule out BPPV)
2. Pure tone audiogram (To rule out noise induced hearing loss or ototoxicity that cause vertigo)
3. Caloric test (To check vestibular reflexes)
These tests can be performed by your ENT specialist.
You will also need a physician's evaluation for blood pressure fluctuations as seen in postural hypotension.
Based on the findings, appropriate medications may be prescribed.
Hope this information was useful. Do let me know if you have any further questions.
Inner ear as cause for vertigo unlikey
Detailed Answer:
Hi. Thank you for writing to HCM.
It is common to have some complaints of dizziness or occasional episodes of vertigo at your age. This is related more to the ageing of the body and delay in visual and auditory reflexes. The more common causes of vertigo at your age is probably postural hypotension ( if the dizziness is triggered when standing up from a sitting position) or BPPV - Benign Paroxysmal Positional Vertigo (if dizziness occurs when you are lying down and changing postures).
Since your MRI is normal( Minimal periventricular white matter changes seem consistent with age) there is no obvious neurological cause.
To rule out an inner ear disease completely you need the following tests
1. Dix Hallpike test (To rule out BPPV)
2. Pure tone audiogram (To rule out noise induced hearing loss or ototoxicity that cause vertigo)
3. Caloric test (To check vestibular reflexes)
These tests can be performed by your ENT specialist.
You will also need a physician's evaluation for blood pressure fluctuations as seen in postural hypotension.
Based on the findings, appropriate medications may be prescribed.
Hope this information was useful. Do let me know if you have any further questions.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dr. Chaturvedi,
Thank you for your prompt and detailed reply. Of course, once I obtained my copy of the MRI, I quickly began to seek information on the internet. Most of what I found related to possible Microangiopathic Disease.
I am in excellent health, watch my diet and exercise, to include yoga, so I was very concerned. I was glad to see your reply.
The vertigo periodically is associated with my going from a sitting position to standing. Reliably, it will occur in a 'backward camel position,, which of course, I no longer attempt in yoga.
Thank you again.
Thank you for your prompt and detailed reply. Of course, once I obtained my copy of the MRI, I quickly began to seek information on the internet. Most of what I found related to possible Microangiopathic Disease.
I am in excellent health, watch my diet and exercise, to include yoga, so I was very concerned. I was glad to see your reply.
The vertigo periodically is associated with my going from a sitting position to standing. Reliably, it will occur in a 'backward camel position,, which of course, I no longer attempt in yoga.
Thank you again.
Brief Answer:
May be postural hypotension
Detailed Answer:
Hi. Thank you once again for writing back.
Good to hear about your positive attitude and maintenance of health.
From what you have written points towards postural hypotension which is common in your age and can also be precipitated with yoga.
You will benefit remarkably from vestibular rehabilitation exercises which you can find easily on the internet and you must perform sitting to standing in a slower fashion to prevent postural hypotension. These exercises will help in strengthening your visual-auditory- balance coordination which is important for preventing vertigo.
Do discuss with all the points that I have shared with your ENT or physician and follow my recommendations based on his/her discretion.
Hoping for your continued good health.
May be postural hypotension
Detailed Answer:
Hi. Thank you once again for writing back.
Good to hear about your positive attitude and maintenance of health.
From what you have written points towards postural hypotension which is common in your age and can also be precipitated with yoga.
You will benefit remarkably from vestibular rehabilitation exercises which you can find easily on the internet and you must perform sitting to standing in a slower fashion to prevent postural hypotension. These exercises will help in strengthening your visual-auditory- balance coordination which is important for preventing vertigo.
Do discuss with all the points that I have shared with your ENT or physician and follow my recommendations based on his/her discretion.
Hoping for your continued good health.
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. Bhagyalaxmi Nalaparaju
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