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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29561
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Found inner ear

Customer Question

About a year ago I asked your help on my "Vertigo" problem. Have had ALL testings. Found inner ear BPPV. Had extended PT therapy. Friend mentioned Dr. Oz said Ginko Biloba helps Vertigo. I didn't believe it but started it 120 mg. every day. This has worked
wonders for me for almost a year. Now I have this VERTIGO back again and VERY BAD. Seeing the same PT again, still taking the Ginko. NOthing seems to be helping. The BPPV is back. Last time I slept in the recliner for 15 mos. Doing that again.

I am also fighting a knee replacement but trying that series of 3 shots first=VISCOSUPPLEMENTATION TREATMENT FOR ARTHRITIS. Therefore I am taking an Ibuprofen now. Was 9 a day, hard on stomach, then 6 a day. Would this have any effect? I'm not sure but I think this started in again before I got on the Ibuprofen.

Please HELP? ANYTHING?
Submitted: 2 years ago.
Category: Health
Expert:  DrThomasMd replied 2 years ago.
Hello
Ibuprofen can cause vertigo in some cases.
Stop this and see what happens.
Talk to your docs.
See an ENT for a maneuver called the Epley maneuver.
Good luck
Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.
Customer: replied 2 years ago.
I have seen ENT. He sent me to PT. She has done the Epley, Brandt, Semont maneuver many many times just as before a year ago. A lot of massage on neck also.
Expert:  DrThomasMd replied 2 years ago.
OK
So
Stop the ibuprofen
See ENT if this does not clear.
Make sure you have an EKG as you just had surgery...rule out hear rhythm problem.
Discuss meds with your doc today.
good luck

Please Click Accept to give answer credit so I am compensated for time and expertise. Come back if needed. Bonuses and positive feedback most helpful. Answers for informational purposes only, not to replace your physician advice or visit.

Customer: replied 2 years ago.
Relist: Inaccurate answer.
he said I had surgery, I did not say that.
Expert:  Dr. Arun Phophalia replied 2 years ago.
Hello,

Ibuprofen may not very likely cause of vertigo in your case. But since it has going on for long without improvement, this should be further evaluated. The causes of vertigo according to the decreasing incidence are;

 

1) Benign paroxysmal positional vertigo (BPPV) 20%

2) Vestibular 15%

3) Migraine and motion sensitivity 15%

4) Anxiety and depression 10%

5) Meniere's disease 7%

6) Cerebellar disease 6%

7) Transient ischemic attacks 5%

8) Orthostatic hypotension 4%

9) Other

 

Your physician may consider MRA (magnetic resonance arteriography). That way any cause related to vascular disorder can be ruled out. MRI with gadolinium enhancement may also be considered, which is particularly useful in detecting smaller intracanalicular tumors such as acoustic neuromas. It is also recommended for identifying sclerotic and demyelinating white matter lesions characteristic of multiple sclerosis. So that can be another investigation considered by your doctor. Chronic dizziness should be also investigated or correlated to anxiety and depression, if all the medical imaging, blood work and examination is negative. If you are on any medications, their side effects also should be ruled out for lightheadedness, as drugs are quite a common cause for this symptom. Dizziness may be provoked by only certain movements, such as standing up after lying down for at least 10 minutes in orthostatic hypotension, or may occur after vertical or oblique head movements, such as lying down, turning over in bed, or sitting up in benign paroxysmal positional vertigo (BPPV). Simply moving the eyes with the head stationary causes dizziness and there is no eye movement disorder (ocular misalignment or an internuclear ophthalmoparesis), then dizziness is likely to be the result of anxiety. When dizziness occurs without provocation (spontaneous) and is vestibular (ear disorder) in origin, it frequently is exacerbated by head movements.

 

Internal ear disease vertigo is termed true vertigo in which one feels rotational movement of self or the surroundings. The false vertigo or nonvertigo has feeling of light-headedness, unsteadiness, motion intolerance, imbalance, etc. You need to discuss your ENT specialist to rule out the diseases of internal ear. They will perform some clinical tests (vestibular diagnostic tests) to establish the cause. Often, dizziness can be a multisensory disorder due to any combination of peripheral neuropathy, visual impairment, and musculoskeletal disease. Many patients who have thyroid dysfunction can present with dizziness as an initial complaint. In individuals who have migraine, dizziness and vertigo can occur as part of the aura or separately. Spells usually last approximately an hour but can last several hours or days in patients who have severe symptoms. Most patients who have migraines have a long history of recurring symptoms. So that too should be assessed as a cause if you have a history of migraine.

 

Your primary care physician should refer your to a neurologist and cardiologist too for an evaluation as the causes can be divided on the system, which is involved;

 

1) Inner ear or internal ear disease

2) Central nervous system

3) Cardiovascular, or

4) Systemic diseases

 

That should be able to conclude for the diagnosis.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 2 years ago.
I have had EKG, MRI, Cat scan, Ultra Sound , seen ENT specialist. Hours
Customer: replied 2 years ago.
I have had EKG, MRI, Cat scan, Ultra Sound , seen ENT specialist. Hours of PT.
Customer: replied 2 years ago.
I was waiting for any input on my REPLY message????
Expert:  Dr. Arun Phophalia replied 2 years ago.
Hello,

Plain MRI may not be able to detect the some lesions like acoustic neuroma, so MRA and MRI with gadolinium are needed. Thyroid function tests and comprehensive metabolic panel would also be advisable.

It is privilege assisting you.

Dr. Arun
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29561
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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