vertigo

[medworm]

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Hi, thought I'd post here and hear your honest feedback. I don't get much of a response from my primary care physician since it's not a serious condition, but I'm just curious about the cause. I recently developed a mild case of vertigo ~1 year ago. When I go down a flight of stairs, for a split moment I lose track of where I am. I'm suddenly disoriented, led to believe that I have slipped when in fact I have not, and have to regain my balance by going down TWO steps instead of the usual one. This happens several times a week. I haven't passed out or sprained my ankle yet, but it's definitely not a sexy thing and probably qualifies me for the freak show. I'm in my 20s, in good health and run regularly. I am slightly anemic (genetics) but vertigo couldn't be related to shortage or oxygen or iron. Weird huh?

 

[Giving My .02]

I suggest seeing a neurologist, we had one that had an interest in vertigo, so look for one in your area and they might be able to help you out.

 

[Wolfkishner]

I suggest seeing a neurologist, we had one that had an interest in vertigo, so look for one in your area and they might be able to help you out.

You also might want to check out an ENT (Ear Nose Throat) specialist. The most common physiological cause of vertigo is a build up of ear crystals in the semicircular canals (which detect proprioception and send signals to your brain to tell you where you are in 3D space). Ear crystals are like fingernails, growing throughout your life, then parts break off/shed, and are normally broken down. Sometimes, your body has trouble breaking down these fragments, they form deposits, and they clog the canals.

Now, you are a little young for ear crystals to be depositing in your inner ear (this normally is seen in more middle-aged people i.e. 40's & 50's), but it's well within the realm of possibilities. There are also several viral causes for vertigo as well, though I would think a viral infection would have cleared your system by now (after a year). Though perhaps the virus caused some underlying damage that hasn't yet been repaired.

An ENT can perform the necessary tests, examining eye movements and nystagmus, to determine if your problem is crystals or viral, or perhaps neurological. Some of the tests are unpleasant (they shoot cool and warm water in your ears), but overall, they're noninvasive and not too bad. If the problem ends up being crystal deposits, there are certain head/neck movements that the ENT will teach you to help move the deposits out of your semicircular canals, so they can be more easily broken down.

Good luck!

 

[medworm]

Thanks! I was about to blame it on the LA smog.

 

[doc05]

Hi, thought I'd post here and hear your honest feedback. I don't get much of a response from my primary care physician since it's not a serious condition, but I'm just curious about the cause. I recently developed a mild case of vertigo ~1 year ago. When I go down a flight of stairs, for a split moment I lose track of where I am. I'm suddenly disoriented, led to believe that I have slipped when in fact I have not, and have to regain my balance by going down TWO steps instead of the usual one. This happens several times a week. I haven't passed out or sprained my ankle yet, but it's definitely not a sexy thing and probably qualifies me for the freak show. I'm in my 20s, in good health and run regularly. I am slightly anemic (genetics) but vertigo couldn't be related to shortage or oxygen or iron. Weird huh?

it doesn't sound like vertigo. Is the room spinning? Are you disoriented to position or time/place?

anemia is not normal. "genetics" isn't a reasonable explanation unless it's something like thalassemia.

you should see a neurologist. best of luck.

 

[OldMD]

I had the same thing when I was 18, it lasted for a few months. I went to the doctor and he wasn't concerned. It mainly affected me when I was going down stairs. It bothered me enough that I went back to the doctor and he gave me some meds... they totally whacked me out and I walked around campus like a zombie for 6 hours, not knowing where I was. Very scary experience (I don't remember what the prescription was for- now that I am in med school I am curious).

It eventually went away... In neuro we learned about Benign Positional Vertigo, where calcium carbonate crystals get lodged in your inner ear fluid. I think that's what it was, and it has never recurred... if you're really worried get a referral to an ENT (I have to find an ENT for a unilateral parotid gland swelling now).

One of the funnest parts of med school is to be able to sit in class and realize that you're learning about something that YOU HAD ("Oh, so THAT'S what that was!)

OldMD

 

[medworm]

For me, anemia is caused by thalessemia. I agree that it's probably a buildup of calcium carbonate -- would you call that earwax? 😉 So before I call the EMT, I'll try an OTC melt-away-your-earwax treatment first.

However, my left ear does blank out and ring sometimes. I'd immediately ask people around me if their ears just "popped" and they'd reply no. And on top of that, I had a recent episode of nauseating vertigo (spinning environment) while driving on a normal day. Scared the crap out of me. Luckily, I didn't get into an accident. I ended up pulling over and wait it out. Certainly makes me appreciate those good old "I'm invincible!" days.

Anyhoo, thanks for the input thus far. 🙂

 

[Prophecies]

For me, anemia is caused by thalessemia. I agree that it's probably a buildup of calcium carbonate -- would you call that earwax? 😉 So before I call the EMT, I'll try an OTC melt-away-your-earwax treatment first.

However, my left ear does blank out and ring sometimes. I'd immediately ask people around me if their ears just "popped" and they'd reply no. And on top of that, I had a recent episode of nauseating vertigo (spinning environment) while driving on a normal day. Scared the crap out of me. Luckily, I didn't get into an accident. I ended up pulling over and wait it out. Certainly makes me appreciate those good old "I'm invincible!" days.

Anyhoo, thanks for the input thus far. 🙂

Be careful--the posters on this board indicated you may have crystals in your INNER ear, where the vestibular system (equilibrium & balance) is located. I don't believe any of them were referring to ear wax, which is typically located in the outer ear. Also, ear wax does not equal calcium carbonate crystals: ear wax is a mixture of secretions from sebaceous glands and modified apocrine glands , while calcium carbonate crystals are...well...calcium carbonate crystals! hehe

Anyway, I think you missed the point of their posts--you need to see a doctor.

 

[doc05]

right. the crystals are located within the inner ear. a neurologist or otolaryngologist can deal with them very easily.

unilateral tinnitus isn't a good sign. you'll need a hearing test, so go see an ENT (not EMT).

 

[scootad.]

I hate to give medical advice over the internet, but I gotta say your vertigo coupled with tinnitus sxs raises suspicion for Meniere's Dz. Go see an ENT.

 

[Stitch626]

I hate to give medical advice over the internet, but I gotta say your vertigo coupled with tinnitus sxs raises suspicion for Meniere's Dz. Go see an ENT.

A Meniere's attack typically involves violent vertigo coupled with vomiting and/or severe nausea. I've witnessed my mother undergo several of these attacks. Seeing that the OP complained merely of split-moment disorientation, probably not Meniere's - but I agree, go see the ENT.

 

[bigdan]

you may wanna try a physical or occupational therapist that does otolith replacement through the Halpike techniques...some of the therapists at our hospital have done wonders with such...

dc

 

[MGoBlueDO]

About Menieres Dz...if you had that you wouldn't be able to move at all...my friend has it and when he had his attacks of vertigo, it disabled him to the point he had to lie down for a long periods...and he lost his hearing gradually as well and wears an implant now.

I had vertigo last year and all I was told is to take benadryll...that knocked me out...but it went away after 5 months... I saw the room spinning and couldn't even walk...like I was drunk, but hadn't drank alcohol in a few months...I looked in the mirror and I think I had nystagmus cause I couldn't even focus...sometimes it just occurs, but I use to play hockey and had a concussion or 2 as well...but I'd see a neurologist if you feel unsafe...there is also something called benign peripheral vestibulopathy...that's when you just randomly get vertigo and it resolves if you had head injuries in the past...just FYI of what I experienced...I'm wondering if it can just be due to stress of medical school? Is that possible?

 

[Tallguy]

i have seen a patient that had meniere's dz with vertigo that was not extraordinarily severe...meniere's dz I believe does not present the same way with respect to severity, signs, and symptoms (some include vertigo, tinnitus and other auditory hallucinations, eventual hearing loss), and there really is not any effective treatments.

 

[BananaSplit]

you may wanna try a physical or occupational therapist that does otolith replacement through the Halpike techniques...some of the therapists at our hospital have done wonders with such...

dc

I agree, you should probably go see an ENT...although you might want to try this first: The Dix Hallpike maneuver (mentioned above) is part of the Epley series of positional maneuvers that return dislodged otoliths to their proper location. I'm sure you can find it online, probably in a journal and do it yourself, especially if you have a good sense of how things are oriented in 3D...or you can have a friend help you do it. I know it sounds crazy to try to do a procedure on yourself, but since it's not invasive in any way, you can try it. You just need a bed and some patience. The pertinent reference is Epley JM: Canalith Repositioning Procedure. Otolaryngology: Head and Neck Surgery 107 (3):401 1992. Mosby-Year Book, Inc. Of course, this will only work if you really have benign positional vertigo and not something else. I'm sure you can also find the diagrams online. My basic neurology professor faxed a copy of it to his colleague who developed BPV, and he did it to himself. Good luck.

 

[noncestvrai]

Very interesting take on the problem, yet this usually occurs in older individuals so I have learned TODAY, but the manoeuvre is totally non-invasive, to say the least.

Go see your family physician, he will refer you to a proper service if needed.

noncestvrai

 

[medworm]

Interesting ... thanks for all the suggestions. I'll look into them.

So upon further introspection, I can isolate my symptoms to the LEFT EAR.

My left ear "leaks" during swimming and gets ear infection afterwards; aches (in other words, hurts like HELL) in the cold or oncoming draft. Rings and pops at weird times (no pressure changes).

Right ear seems okay. Yet I don't have a hearing problem.

My RIGHT EYE hurts sometimes -- but again, I don't think it's serious b/c I don't have any diseases, just thalassemia. I am nearsighted w/astigmatism.

Well, what do you say -- I just might be my first patient.

 

[medworm]

???

Just curious.

 

[Prophecies]

The calcium carbonate crystals are a normal part of the auditory system, located within the saccule and utricle of your ear. When they dislodge and migrate into the semicircular canals, usually they will dissolve or return to their appropriate location; sometimes they don't, and that's how the trouble begins. Really...you should go see a doctor...really.

 

[medworm]

One last question -- is this serious or can this wait? I'm not vomitting. Is seeing an ENT a want or a necessity? Tallguy mentioned that there isn't an effectice treatment.

The reason being that I don't have health insurance right now. I should have a job in 6 months.