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What causes persistent shaky vision and right earache post recovery from sinus infection?

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Posted on Mon, 9 May 2016
Question: My 11 year old son has been complaining of shaky vision and constant earache in right ear for the past 6 weeks. He had a sinus infection prior to this and was on 7 day cruise and transatlantic flight. His ears are normal on examination and he passed neurology examination. The doctors are saying it is post viral syndrome but he is miserable. Please help
doctor
Answered by Dr. Erion Spaho (58 minutes later)
Brief Answer:
Vision and vestibular rehab therapy, consider imaging too.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

The condition that you refer about your son's is known as vestibular neuritis that is usually seen after viral infection.

Since your son passed successfully ears examination and neurological evaluation didn't found any neurological disorder, the symptoms should subside with time.

Improvement needs combination of Vestibular rehabilitation therapy with vision therapy.

If Herpesvirus is found / suspected as the culprit, antiviral treatment with acyclovir may be needed.

However, in my opinion, to confirm that there are no structural lesions, since there is ear pain too, such inner ear infection, mastoiditis and a few other conditions that may cause these symptoms, imaging studies such brain MRI is needed.

These issues should be discussed with a Pediatrician that deals with neurological or ENT disorders.

Hope you found the answer helpful.

Let me know if I can assist you further.

Greetings.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho (22 minutes later)
Thank you for your reply. My son was seen by the ENT doctors and they said his ears were perfect-----would they not have seen vestibular neuritis?. How can I find out about Vestibular rehabilitation therapy with vision therapy. His vision is shaky as opposed to spinning. He is also quite pale and gets tired easily but other than that he is eating well etc. Thank you
doctor
Answered by Dr. Erion Spaho (1 hour later)
Brief Answer:
Vestibular neuritis is a feature of post viral syndrome.

Detailed Answer:
Welcome back and thanks for being on follow up.

Probably Doctors referred with other words to vestibular neuritis when they mentioned post viral infection syndrome.

It is a condition assessed mainly by evaluation of clinical data.

Vision therapy aims to improve vision skills such as eye movement control and eye coordination. It is carried out by Optometrists.

Vestibular rehab therapy is an exercise-based program primarily designed to reduce vertigo and dizziness (if any) and gaze instability. It is carried out by ENT specialists.

Exercises used by both therapies can be done initially at specialist office and can be continued subsequently at home.

Hope this helps.

Best regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho (29 minutes later)
Thank you. How long do you think it will last for and why does he seem in good form and then say that he feels really bad, His ear really annoys him as does the shakiness. Thank you
doctor
Answered by Dr. Erion Spaho (30 minutes later)
Brief Answer:
Most cases resolve in few weeks.

Detailed Answer:
Welcome back.

Symptoms improve in most cases within few weeks.

Only few cases experience recurrence of episodic symptoms longer.

A brain MRI could give additional valuable information about your son's actual underlying condition.

Hope this helps.

Greetings.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Erion Spaho (33 minutes later)
Thank you. What is the underlying condition? He has had this for 6 weeks already
doctor
Answered by Dr. Erion Spaho (4 minutes later)
Brief Answer:
Spreading of infection for example.

Detailed Answer:
Hello again.

Underlying condition may be for example spreading of viral infection into mastoid cells or inner ear.

This possibility should be evaluated further / excluded because of the ear pain.

Hope I helped you.

Take care.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4272 Questions

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What causes persistent shaky vision and right earache post recovery from sinus infection?

Brief Answer: Vision and vestibular rehab therapy, consider imaging too. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. The condition that you refer about your son's is known as vestibular neuritis that is usually seen after viral infection. Since your son passed successfully ears examination and neurological evaluation didn't found any neurological disorder, the symptoms should subside with time. Improvement needs combination of Vestibular rehabilitation therapy with vision therapy. If Herpesvirus is found / suspected as the culprit, antiviral treatment with acyclovir may be needed. However, in my opinion, to confirm that there are no structural lesions, since there is ear pain too, such inner ear infection, mastoiditis and a few other conditions that may cause these symptoms, imaging studies such brain MRI is needed. These issues should be discussed with a Pediatrician that deals with neurological or ENT disorders. Hope you found the answer helpful. Let me know if I can assist you further. Greetings.