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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Frequent Vertigo Attacks Since Four Months With Weakness,losing Weight And Bed Ridden

I have been having vertigo attacks on and off for four weeks now. I even had to be wheeled out of the airport before flying on holiday as my vertigo was so bad. My right ear is blocked and tinnitis is constant but mild, until vertigo attack comes on then its really bad. My doc has given me stemetil which isn t really doing anything and a nasal spray to clear my ears. They say it s viral labrynthitis as my ear drum is bulging but it s been 4 weeks now, I m off work and the vertigo episodes have had me violently vomiting and bed ridden and can t seems t o shift it. This, in itself, has left me weak, tired and losing weight Please can you recommend what to do. Thank you.
Sat, 5 May 2012
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Otolaryngologist / ENT Specialist 's  Response
Hi,



Thank you for your query.



1. 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. Other medication besides stemetil may include anti-viral medication, a low salt diet, diamox, vertin or stugeron.



2. Labyrinthitis involves both the cochlea and the vestibular labyrinth. If you do not have hearing loss, your diagnosis cannot be labyrinthitis. It may be vestibular neuritis alone. You should get a PTA (Pure Tone Audiogram) to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( Audiogram sloping to left).



3. Get a Tympanogram done to check middle ear pressures. If this Impedance Audiogram is normal, it may be Meniere's as it does not affect the middle ear.



4. Do you have history of any illness - ear / neck related problems or head injury? Any headaches or migraine? Any hyperacidity or recent cold?



5. I will be able to guide you better about the possible cause if you can provide me more details of your dizziness like:

a. The exact moment when it all started,

b. How often and how long do the episodes last? Is it continuous?

c. Any other associated symptoms, such as nausea, vomiting or sweating?

d. I need to know if your hearing is normal. Does it fluctuate? Do you get the sounds (tinnitus) or fullness in one or both ears? Has any doctor checked your eardrums?

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? Does 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?



6. It is also important to consult a neurologist to rule out neurological degenerations that can cause such symptoms. (MRI scans may not be enough to pick these conditions).



Regards.
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Frequent Vertigo Attacks Since Four Months With Weakness,losing Weight And Bed Ridden

Hi, Thank you for your query. 1. 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. Other medication besides stemetil may include anti-viral medication, a low salt diet, diamox, vertin or stugeron. 2. Labyrinthitis involves both the cochlea and the vestibular labyrinth. If you do not have hearing loss, your diagnosis cannot be labyrinthitis. It may be vestibular neuritis alone. You should get a PTA (Pure Tone Audiogram) to document any hearing loss. Meniere s disease usually causes low frequency hearing loss initially ( Audiogram sloping to left). 3. Get a Tympanogram done to check middle ear pressures. If this Impedance Audiogram is normal, it may be Meniere s as it does not affect the middle ear. 4. Do you have history of any illness - ear / neck related problems or head injury? Any headaches or migraine? Any hyperacidity or recent cold? 5. I will be able to guide you better about the possible cause if you can provide me more details of your dizziness like: a. The exact moment when it all started, b. How often and how long do the episodes last? Is it continuous? c. Any other associated symptoms, such as nausea, vomiting or sweating? d. I need to know if your hearing is normal. Does it fluctuate? Do you get the sounds (tinnitus) or fullness in one or both ears? Has any doctor checked your eardrums? 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? Does 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? 6. It is also important to consult a neurologist to rule out neurological degenerations that can cause such symptoms. (MRI scans may not be enough to pick these conditions). Regards.