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Vertigo, vomiting following ear wax removal.Tried Meclizine, but no help. What can I do ?

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VErtigo, vomiting following ear wax removal.Tried MEclizine. What else it can be done? The veritgo and vomiting is on going.
Posted Fri, 13 Jul 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 9 hours later

Thank you for your query.

1. Your sensation of nausea, vomiting and dizziness seems to be related to the ear wax removal. Is it possible that there was an injury to the ear during wax removal? What was done, syringing (flushing out with water) or removal under a microscope (otomicroscopy)? Was the eardrum visible after wax removal? Was it intact? Was there any infection (sometimes fungal) behind the wax?

2. I will be able to guide you better about the possible cause if you can provide me more details of your dizziness and tinnitus like:
a. The exact moment when it all started, was there any pain during wax removal?
b. How often and how long do the episodes last? Is it continuous?
c. Any other associated symptoms (in addition to vomiting) such as retching or sweating?
d. I need to know if your hearing is normal. Does it fluctuate? Do you get any fullness in the ear?
e. Is the dizziness true vertigo (spinning of the surrounding) or only unsteadiness.
f. Is the dizziness only when there is change of position (such as lie down or sit up)? Can you walk without support? Do you get dizzy when you turn in bed or look up while climbing stairs?
g. Is your vision clear or blurred? Is there any tendency to blackout?

3. I am assuming that your hearing (Pure Tone Audiogram) and middle ear pressure (Tympanogram) is normal and Meniere's Disease has been ruled out along with common causes such as anemia (low hemoglobin), blood pressure changes (Orthostatic hypotension). (Meniere's Disease includes fluctuating hearing oss, Vertigo, Tinnitus and Fullness in the ear).

4. Direct observation of any vertigo induced nystagmus (abnormal eye movements) always helps in the diagnosis. A physician's examination is recommended as you cannot observe it yourself. The direction and characteristics of the nystagmus will give an indication of the presence of any acute ear injury.

5. Instead of Meclizine, you will find better relief with Stemetil (prochlorperazine 5mg BD, preferably MD or mouth dissolving), Stugeron (cinnarizine 25 mg TDS) or Vertin (betahistine 48 mg OD). However these should only be taken under medical supervision. Any other cause such as underlying infection or injury will also have to be treated.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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