Question: I developed impaired balance and non rotational vertigo 4 years ago after giving up smoking. The symptoms are chronic and consistent although vary in intensity from barely noticeable to quite limiting. The variation in intensity seems to come and go in two to three month waves. I also suffer from cognitive dysfunction in the mornings. I was given a diagnosis of Meniers disease 1 year after the initial symptoms started. This was based on a positive ECOG (of the inner ear) which showed hydrops. However I am not convinced my symptoms are consistent with this condition (ie attacks of rotational dizziness, vomiting etc).

I've had several MRIs of the brain and spine over the past 3 years. The first showed 3 small white spots. The most recent showed 7 to 8 spots. The Neurologist said the change in number was due to changes in scanner type and software sophistication (slice thickness). He says there is no evidence of disease process and I do not have MS.

Another consistent finding on all of the MRI's is some type of reference to blocked sinuses. For example, on my latest MRI it said: "moderate to severe T2 hyperintense polypoid Mucosal Thickening within the Maxillary Antra, moderate T2 hyper intense Mucosal Thickening with the right frontal sinus and mild Mucosal Thickening within the bilateral ethmoid air cells, left frontal sinus and right sphenoid sinus." Although I do not suffer from traditional sinus pain / symptoms, I do often feel as if I am wearing a mask (ie a sensation around my eyes, as if I am wearing a small mask), TMJ pain and pain in my eyebrows on palpation. I have suffered from bouts of fatigue / weakness in the past, although currently I am fine. I previous ENT Dr had told me I had rinosinusitis and that I have nasal polyps. I am allergic to pollen and dust mites. I also had dental surgery (one filling and tooth extraction on the right hand side ) soon after the symptoms started, which seemed to make the symptoms worse things worse. The filling (borderline root canal) has consistently caused pain / abscess on and off ever since.

By coincidence, I noticed that my symptoms clear up when I'm taking Predisone. A few months ago I was hospitalised for severe bacterial tonsillitis and given IV dexamethasone (one bout 10 mg) and IV antibiotics three times a day for two days followed by the same AB's orally for 7 days (Metronidazole and Cephalexin ). The symptoms went into almost complete remission immediately and continued to improve for four months afterwards (I then had a complete relapse). I had also previously noted that nasal steroid sprays reduce the symptoms, but if I take for a more than a few days I seem to get a URI.

Do you think my symptoms could be caused by chronic sinusitis? If so, what treatment do you recommend? Should I repeat the IV steroids and antibiotics. I can't take the nasal spray for the reason mentioned above.