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I was diagnosed with post-viral vestibular dysfunction after

Hi,I was diagnosed with post-viral...
Hi,I was diagnosed with post-viral vestibular dysfunction after awakening the morning of 2/6 with dizziness concurrent with the onset of a cold that kept me out of work for seven days. I have had both a VNG test and a MRI brain scan, both of which were normal. The dizziness is getting better; however, I still have hills and valleys toward recovery. This was the projection of the ENT. What has me most concerned presently is the level of muscle fatigue I have experienced. Particularly when it was over 100 degrees this summer, being out for just a couple blocks would cause considerable fatigue (although could still walk, lift objects, etc.) that would last around two hours until I felt normal. I have been going to physical therapy and get through the exercises fairly easily but find it difficult to do them at home from the resultant "heavy legs" I feel in subsequent days. The fatigue/soreness is primarily in the upper hamstrings/glutes, although occasionally also in my biceps. The general consensus from the doctors I have seen is the symptoms are due to muscle atropy due to lack of use as I have not exercised since the on set of the dizziness on 2/6. I have seen two ENT's. The first said the positive brain scan ruled out MS (99.99% ruled out); however, she said neurologist look at things differently and asked if I wanted a referral. The second said fatigue is not generally associated with vestibular disorders, but I have read differently and heard from others who have experienced fatigue from this condition. My question is whether given the above it would be prudent to get blood tests for Creatinine Kinase and any other tests for autoimmune disorders in spite of the normal brain MRI. In addition, would a EMG test be warranted? Please ask me any other questions that my help you with your evaluation of my condition. Thank you.
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Answered in 2 days by:
9/22/2017
Dr. Mo
Dr. Mo, Board Certified MD
Category: Medical
Satisfied Customers: 1,240
Experience: Urgent Care Physician
Verified
I don't think a CK test would give much more information though it is a simple test to run. An EMG would be advisable if you had weakness that was very specific to a muscle group and could be demonstrated on a clinical exam.
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Customer reply replied 1 month ago
My PCP said that would see results of CK tests to determine whether to refer to neurologist. I am in physical therapy know can do all the exercise, and even did 20 push-ups on Tuesday, but I find that I am quite sore for days after. I have not exercised since last January, and was quite sedentary (often laying in bed when got home from work) due to the dizziness, which is gradually getting better. PCP said a high CK test would be indicative of a problem. What would the CK test reveal? PCP does not even want me to go ENT scheduled for October, just says probably will not find any problem and just live with it. Of course, he did not approve the brain scan either. Had to get from ENT as a result.I have more or less stayed off the next due to not wanting to put myself under more stress. I had a panel of tests today including CK, CBC, total and free testosterone, etc. I don't really have a weakness to the extent I cannot do things such as PT, but I have the "heavy legs" and more fatigue than normal.Have you seen the type of situation I have? Hopefully just muscle atrophy that PT can resolve in time. Please feel free to ask me more questions, and I can ask you new questions to better compensate you for your time. Thank you!

The dizziness will get better and better as you do more exercises, it has to do with desensitization of your vestibular system. 20 pushups is impressive, I'm not surprised you're sore and probably would be sore for a few days in a row.

A Total CK tells us if there is significant muscle breakdown from various causes. This would result in constant muscle swelling all over and swelling in the extremities. It is often caused by medications such as cholesterol medications but can be caused by other illnesses as well.

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I am very reassured that you are able to do the exercises with nothing but heavy legs, that's a good sign. I do believe that you'll improve a lot with PT.

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I have the following questions for you which you can answer at your convenience:

  1. is the muscle weakness/heaviness always on both legs at the same time?
  2. do you get muscle weakness/heaviness anywhere else on the body?
  3. is it always related to exercise or at other times as well?
  4. have you seen a lot of muscle twitches on your body?
  5. any sensory loss or changes?
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