How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29729
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
5625079
Type Your Health Question Here...
Dr. Arun Phophalia is online now
A new question is answered every 9 seconds

Hi--In 2005 I woke up with vertigo as if the room was tilting/spinning--

Resolved Question:

Hi--In 2005 I woke up with vertigo as if the room was tilting/spinning-- the first 24 hours can barely move and vomiting/dry heaving, then the next 2 weeks extreme off balance , motion sickness----everything fine until the above symptoms happened in 2007 this time lasting about 4 weeks, since then never felt the same, never a day without a slight nausea feeling, and hard to look up or move to fast with out the motion sickness feeling. My doctor said it is vertigo and it can last 3 days to 9 months. ( I got use to the nausea and motion sickness I let it go) May 10, 2013 the vertigo (where it feels the room is spinning happened again. I have not been able to recover from this one (its now June 26, 2013) now I am experiencing a more extreme nausea and if I move too much the room starts spinning around and I get even more nauseated. If I am lying down and turn my head to the right the room spins around and my eyes feel like they are twitching and my head instantly gets nauseated and I get a tingling sensation in my head as if your hand falls asleep, I have been to the doctor 3 times since May 10, 2013 my doctor says the same thing its vertigo give it time, I was off work for 3 weeks then tried to go back and on the 2nd day had to leave due to extreme discomfort with the above symptoms, then went back to the doctor and he said bed rest, I tried again to go back to work this week made it 2 days, and again the extreme nausea, if I move it sets in and motion sickness, it is basically a minute by movement thing. I am 46 years old, I work as a claims rep for a insurance company, I have to work, I can go on disability, but I'm hoping this will end soon, please advise, just get rest as I have been or get another doctor? Please advise--thank you
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.

Hello Lisa,
I am Dr. Arun and will be helping you today.

What are the specialists you have consulted?
What are the investigations done?

Any significant past medical history like migraine, low thyroid?

Customer: replied 1 year ago.

Hi--only seen by my Doctor specializes in Internal Medicine. No migraines no low thyroid. No tests done of any kind, my doctor said my symptoms do not warrant any.

Expert:  Dr. Arun Phophalia replied 1 year ago.
Hello,

Your primary care physician should refer your to a neurologist, cardiologist and ENT specialist for 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

 

The causes of vertigo and dizziness 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


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 consult first an ENT specialist to exclude 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.

 

Following are the investigations which will clinch the diagnosis;

1) audiometry,
2) vestibular tests.

 

The most commonly performed vestibular tests are as follows:

Electronystagmography (ENG)The rotating-chair test, also referred to as sinusoidal harmonic acceleration (SHA), Computerized dynamic posturography (CDP).
3) blood tests for autoimmune disorders,
4) computed tomography (CT), and magnetic resonance imaging (MRI).

5) The saccadic test
6) The gaze test
7) Pursuit eye movements test
8) Optokinetic Nystagmus test
9) Head shake nystagmus test.
10) Positional nystagmus testing
11) Bithermal calorie test.
12) Rotating chair test.

13) An alternative to the rotating-chair test is the active head-rotation test,

14) Computerized dynamic posturography

 

An ENT specialist and a neurologist with a Rehab specialist in tandem are involved in the investigative work up and care.

 

MRI with gadolinium enhancement is also 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 / vertigo associated with the floating, rocking and light headedness and is induced by eye movements (head being still) 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.


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

 

We have recently implemented a new rating and feedback system. Please be aware that you are rating my courtesy and service as a professional. If you have any questions whatsoever, or there is anything I can clarify for you, please temporarily bypass the rating system by clicking “Continue the Conversation” or "Reply."

Clicking either of the lowest two options reflects poorly on me so please reply to me if there is anything else I can do to help before choosing those options. I appreciate your patience while we work out the kinks. It's important to me that you are 100% satisfied with the service I have provided you. Thank you.
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29729
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 2 other Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/NU/nursescare4u/2013-3-31_03429_JApic.64x64.jpg Nurse Milli, RN's Avatar

    Nurse Milli, RN

    Nurse (RN)

    Satisfied Customers:

    4043
    20 years experience in many areas of Nursing. Both Hospital and Private Practice experience.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Doctor

    Satisfied Customers:

    102
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor (MD)

    Satisfied Customers:

    5622
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/drphophalia/2007-08-23_095626_dr._arun_phophalia.jpg Dr. Arun Phophalia's Avatar

    Dr. Arun Phophalia

    Doctor (MD)

    Satisfied Customers:

    17025
    MBBS, MS (General Surgery), Fellowship in Sports Medicine
  • http://ww2.justanswer.com/uploads/VA/VANP/2012-6-6_235535_Skye2.64x64.jpg A. Schuyler, NP's Avatar

    A. Schuyler, NP

    Nurse Practitioner

    Satisfied Customers:

    12170
    Board Certified NP, MS, RN. Private practice & hospitalist
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Doctor (MD)

    Satisfied Customers:

    10029
    Over 20 yrs of Family Practice
  • http://ww2.justanswer.com/uploads/neurosurg/2009-10-06_120923_profile.jpg Dr. Mark's Avatar

    Dr. Mark

    Doctor (MD)

    Satisfied Customers:

    6234
    U.S. Physician/Surgeon in Neurosurgery