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What causes tinnitus and vertigo?

Answered by
Dr.
Dr. Vinay Bhardwaj

Neurologist, Surgical

Practicing since :2006

Answered : 544 Questions

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Posted on Wed, 24 Sep 2014 in Ear, Nose and Throat Problems
Question: Since yesterday, there has been a ringing sound in my ear often increasing and decreasing. It is quite loud often and annoying. I am also experiencing dizziness like the Earth is moving under me. It started almost after I finished lunch yesterday
doctor
Answered by Dr. Vinay Bhardwaj 7 hours later
Brief Answer:
Vertigo, Tinnitus and their causes

Detailed Answer:
Hi XXXX, Thanks for coming to HealthCareMagic. The loud increasing and decreasing sound you are experiencing is called Tinnitus and the dizziness is also referred to as Vertigo.

Now, as it happens, these two symptoms are related. They are both caused by interference in the signalling sent from the inner ear to the brain (the inner ears have organs which give us a sense of balance in 3 dimensional space).

I suspect that there is some sort of issue you are having in one ear or the other. Have you had any ear ache or pain? That would be the most simple explanation. If there is no such ear symptom. Then we have to get your ears examined by an Ear Nose and Throat doctor. They would be able to look into your ears and see whats going on.

For the time being, try and cut back on caffeine (coffee, and dark colored sodas, chocolate) and salt (most in packaged foods) and make sure you are getting plenty of rest. You can also go to your pharmacy and use 'Vertin' for your dizziness. But beware, it makes you very sleepy.

So, to sum up. If you have ear symptoms.. then you need to see an GP or ENT right away. If you don't have ear symptoms, then wait and watch for awhile to see if the lowered caffeine and lowered salt intake help. If they do not, then you will need to get to an ENT in the end.

Make sense? Let me know what you are thinking.

Vinay.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vinay Bhardwaj 29 minutes later
I had gone swimming and felt a bit of pain/irritation while in the water but apart from that, there isn't much pain. I don't usually drink coffee but I have felt a general sense of tiredness today
doctor
Answered by Dr. Vinay Bhardwaj 31 minutes later
Brief Answer:
2 Possibilities same process and treatment

Detailed Answer:
Hey XXXX Thanks for the follow-up. The history of swimming is definitely significant to your situation, glad you filled me in.

The way I see it, you have 1 main pathological process going on, and either of two environmental issues may have started the process.

The pathology is inflammation. Swelling.. particularly in the tube that connect the middle ear to the throat. Its called the Eustachian Tube. It's job is to equalize the pressure between the inner ear and the rest of the environment.

When it gets inflamed, the inner ear becomes a sealed bubble that is getting pressed upon by the pressure of the atmosphere. This will irritate that delicate balance organ IN the inner ear. Causing your symptoms.

Now, what caused this inflammation? I'll bet it was caused by either

1) An infection in your throat that spread to the Eustachian tube and caused it to swell

2) Irritation from high chlorine content in the pool water. Chlorine can be swallowed while swimming and irritate the Eustachian tube. Leading to the same outcome.

Now, finally. How shall we treat this?

We need to decrease inflammation in the throat and Eustachian tube.

The best way I know is to use an anti-inflammatory medication and warm fluids. Both of which tend to decrease inflammation.

One of the safest and best known anti-inflammatory medications is Aspirin.

What I want you to do is crush a 325mg plain aspirin tablet and mix it with HOT water. Gargle this mixture and repeat a few times. For the rest of the day I want you to be sipping hot water other warm liquids (tea / coffee are fine). This will begin to open up the Eustachian tube directly.

If you develop a fever, then I would suggest a course of Antibiotics and possibly steroids if your dizziness does not settle. But that is a remote possibility. So lets not worry about it for now.

To summarize, sip warm liquids and gargle Aspirin with HOT water a few times. See if it helps. If it doesn't, you will need to head for an ENT doc.

Vin

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vinay Bhardwaj 2 days later
Good evening, Dr XXXXXXX

I took your advice and visited an ENT doctor nearby. The first day, he cleaned out my ear and the sound didn't go. He told me to take an audiometry test and prescribed a tablet "Stugeion" for the dizziness. However, that hasn't decreased.
In the audio metry test, thy said that my hearing was alright but in one case the sound they played was the same as the one in my ear so I wasn't able to distinguish it. The provisional diagnosis was "Bilateral hearing sensitivity within normal limits with an 8 khz dip for right ear"

The doctor who i met after 2 days, today said that there probably is some nerve weakening and prescribed Nervigen and complamina retard for a month and told me to visit after a month.

Do you think I should visit a different ENT or continue with this prescription ?

I would like to add a few more facts :-
1.I have been taking homeopathic medicine for about a month (for pimples).
2. I have been feeling very tired in my hands and suddenly dehydrated often.
3.The sound increases/is more of a disturbance when people speak into my affected ear
doctor
Answered by Dr. Vinay Bhardwaj 24 hours later
Brief Answer:
Am not convinced

Detailed Answer:
Hi XXXX, thanks for following up. I'm not really convinced that you have any kind of nerve weakness based on the report you have provided. I'm more inclined to believe that your inner ear is being irritated by some form of inflammation, as i described before. But here is the thing... I'm not an ENT doc and they are the experts when it comes to these things. I would strongly suggest you get a second ENT opinion.

When it comes to taking Stugeron, Nervigen and Complamina. The stugeron is supposed to help you with the dizziness, but it takes a week or two for the effect to set in. So you can stick with it. Nervigen is a vitamin supplement and is fine as well, even if you are not vitamin deficient, it will do you no harm. The Complamina has an interesting effect. it's supposed to increase the overall bloodflow to the brain and inner ear. It's effect also takes time to build up and it is known to help with these situations, so again, no harm in continuing. .

I wish that you would stop the homeopathic medicines for awhile simply because i have no idea what effect they may have in concert with the allopathic meds that you are taking, the interaction between these different classes have never been studied and stopping the homeopathy would simplify the situation. I am tempted to say that your tinnitus and dizziness MAY be a side effect of the homeopathy.. but i've never studied homeopathy meds so I can't be sure.

Dehydration and fatigue can be related to the effect of stugeron, which has a slight antihistaminic effect.. which can lead to fatigue (sleepiness) and dehydration.

The fact that speking into the affected ear makes things worse makes sense to me. It would worsen the inflammation. There's not much you can do about that for now. I would avoid swimming and using your earphones to try and rest your inner ear a bit.

I would also encourage you to post a query regarding your situation using the "Ask a Specialist" service. We will make sure that the query goes to an ENT and you can get in touch with an ENT directly.

To sum up, i would continue the prescription AND get a second opinion as soon as possible. I don't want a deeper problem to be missed with a vague diagnosis like "nerve weakening". I never trust such diagnosis.

I hope this helps,

Vin
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Vinay Bhardwaj 2 days later
Thanks a lot, Dr. XXXXXXX I'll do that
doctor
Answered by Dr. Vinay Bhardwaj 10 minutes later
Brief Answer:
Glad I could help a bit

Detailed Answer:
Hey there, I hope I helped a bit at least. If you feel I can be of any use to you in the future, just drop me a line.

Vin
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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