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Dr. Andrew Rynne

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What could be the cause for spinning head and off balance?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2563 Questions

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Posted on Fri, 6 Dec 2013 in Ear, Nose and Throat Problems
Question: Last Sunday I woke up with room violently spinning, I sat up and it threw me back in bed for a couple of sec...went XXXXXXX the next day and he said could be labrynthis or meneieres.. Scheduling for hearing text tomorrow a week later... My friend who is a neuro did the epley maneuver 2x one after the other on Tuesday.. The spinning stopped but I am still off balanced... When I sit down I feel like I am swaying or get the falling sensation but don't fall... What could this be?? Help..is it normal 7 days later to still have this swaying feeling.. It's a little better than last week. But I feel like am moving or my head is moving when I am sitting down...I am getting scared that this is so etching more serious...
doctor
Answered by Dr. Sumit Bhatti 46 minutes later
Brief Answer: There is no cause for worry. Detailed Answer: Hi, Thank you for your query. 1. Your description seems to fit the diagnosis of BPPV (Benign Paroxysmal Positional Vertigo). BPPV is very common. 2. This is a normal part of the compensation and imbalance process. Patients recovering from BPPV also experience dullness. Some refer to it as 'brain fog', which improves and disappears within a few days or a couple of weeks. 3. Sometimes, a few particles may remain or enter other semicircular canals causing persistent unsteadiness. You may insist on an ENG (Electronystagmography) if your unsteadiness persists. 4. Sometimes, a few particles may remain stuck to the cupula of the semicircular canal. Ultrasound assisted Epley's may be used to dislodge these particles. 5. An Epley's maneuver can convert a posterior canal BPPV into an Anterior Canal BPPV which is more difficult to treat. 6. You may do Brandt-Daroff and Semont's exercises/maneuvers at home in addition. 7. I usually use a DizzyFix device, and then ENG aided Epley's if there is incomplete relief. You may have to sleep upright for two days after an Epley's (which is a difficult proposition). The Omniax System is like a computerized astronaut chair, which is used in resistant cases. 8. If you are not better in a couple of weeks, I would advise a re-evaluation, preferably with an ENG (ElectroNystagmoGraphy). BPPV is known as 'Benign' as it usually subsides in a few months even without treatment. With the Epley's maneuver, recovery should be quick. There is no way of predicting another attack. Many patients have no recurrence. 9. Meniere's disease is diagnosed on the following criteria: a. Vertigo b. Fluctuating hearing loss c. Tinnitus d. Fullness in the ear. There is usually nausea and vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. This condition develops suddenly or slowly and erratically and varies from person to person. There is initially a hearing loss in the lower frequencies in Meniere's Disease (slope to left). Get a PTA (Pure Tone Audiogram) done. 10. In Labyrinthitis, there is hearing loss in addition to vertigo. There is usually no hearing loss in BPPV. 11. Remember that multiple causes may co-exist and must be treated for complete relief. Cervical spondylosis and central causes (such as mild hypertension) can intervene, causing slow recovery. I hope I have answered your query. If you have any further questions I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 13 minutes later
It comes in waves, especially when I a am sitting.. Did u ever have that feeling when you're sleeping that ur going to fall... A falling feeling only I have not fallen.. Or if you are sitting and fall asleep and your head falls and makes you jump.. That kind of felling. I feel like something is seriously wrong it's days 7 that I am feeling that way.. The ent wanted to wait a week for vertigo to settle to do hearing.. Have 2 little kids who need me. He is very relaxed about it should I go somewhere else? Or neuro or will ent run all the same test .. Who will help me get rid of this feeling quicker Also he checked my ear with light and nose and said all fine.. So how can it be an ear problem if he said they looked good?
doctor
Answered by Dr. Sumit Bhatti 41 minutes later
Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. Request a medication for the waves of unsteadiness, though in BPPV, it is not always necessary. This is required as you have to children to look after. 2. Recovery takes a few weeks. 3. Get the audiometry tests done. 4. The eardrum and canal always look normal. The problem arises in the inner ear which is encased in the temporal bone and cannot be examined with the otoscope. I hope I have answered your query. If you have any follow up queries, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 2 days later
I had the hearing test and came back normal actually excellent. I am scheduled for a eng and vng next week. I feel like something in my head is shaking is that normal.. Hard to explain I feel like I am swaying but not noticeable if some is looking at me... And off balanced happens when I am sitting rather than standing. Sooo scared
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Brief Answer: You will recover soon. Detailed Answer: Hi, Thank you for writing back. 1. If your hearing test is normal, then it is more likely to be BPPV. 2. Go ahead with the ENG and VNG. 3. The feeling of imbalance is common. 4. The brain requires 6 to 8 weeks to 'reset'. Continue the rehablitation exercises. I hope I have answered your query. If you have any follow up queries, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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