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Sustained cranial and vestibular concussion. Taking vestibular therapy. Suffer nausea. Having stiff neck with headaches. Remedy?

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ENT Specialist
Practicing since : 2006
Answered : 1113 Questions
Hi Dr. I sustained a cranial and vestibular concussion in Feb 2013. I have been taking vestibular therapy, but to no avail. I suffer from nausea 100 % of the day, have trouble eye tracking, everything moves up and down and from side to side. I can feel my eyes jerking and constantly try to keep things still in my vision...resulting in a major stiff neck with headaches, nausea/motion sickness and also have bouts of clammy sweat breaks when the nausea hits and then bouts of chills. I visited Panama Setpt 2012 and am wondering if I have picked up something in addition to the concussion symptoms that are getting worse. I have been off work since the accident in Feb 2013 where I hit my left temple running into an unseen floating staircase in the dark. I would welcome your suggestions. My doctor has recently put me on an antidepressant and a sleeping pill but still I spend most of the day in bed trying to get relief. Early on I had a CT Scan, MRI, saw a neurologist and was told it will just take time. It has been 9 months now and I feel that I am getting worse, not any better what so ever. I look forward to your reply. thank you. XXXXX.
Posted Tue, 5 Nov 2013 in Ear, Nose and Throat Problems
Answered by Dr. Hariom Sharma 21 hours later
Brief Answer:
Perilymphatic fistulas

Detailed Answer:
Hi Mam,
I have gone through your query.

It suggests that you may be suffering from perilymphatic fistulas (PLFs).
Diagnosis can be confirmed by performing a tympanotomy and directly viewing the area of the suspected fistula. If a perilymph leak is seen, a perilymph fistula is assumed to be present.

But first your doctor should exclude the other post-traumatic causes of the vertigo such as Benign paroxysmal positional vertigo, eighth nerve complex injury, posttraumatic Ménière syndrome and labyrinthine concussion.

For your kind information, proper diagnosis of the exact vestibular disorder is the key to successful management.

For better diagnosis and management you may go for -
Pure tone audiometry, Impedance audiometry, Electronystagmography, Rotary testing, MRI of the temporal bone and XXXXXXX auditory canal and CT scan of the temporal bone.

The right specialist to visit is a Neurotologist in your area. They are trained in such disorders. They would be available in specialized centres.

I stress on proper diagnosis first.

Wish you good health
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