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Vertigo. Woke up unsteady. for a few days left ear felt

clogged like a wax ball...
Vertigo. Woke up unsteady. for a few days left ear felt clogged like a wax ball needed to drop. today sore right knee. tingle sensation in right calf and thigh.
JA: What seems to make the symptoms worse or better? Have you noticed any swelling?
Customer: History of MS and trigeminal neuralgia
JA: Anything else in your medical history you think the doctor should know?
Customer: no swelling. Generally good health other than the MS and TN
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Answered in 2 minutes by:
9/26/2017
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 36,108
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified

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Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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What is your age and gender?

What are the medications you are taking?

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Customer reply replied 1 month ago
Male Caucasian. 58. Lisinopril border line hypertension. Betaseron for MS.

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Sorry for the delay. I was logged out and there was technical issue which was letting me log in.

Tingle sensation is right calf and thigh can be due to;

pinched nerves in the back. This can be due to;

1) Herniated/degenerated disc in back

2) Lumbar spondylosis; bone spurs in the back vertebrae pressing on the nerves.

Following investigations would be required;

1) X-ray of the lower back

2) MRI of the spine

3) Nerve conduction velocity (NCV) study

4) Electromyography (EMG)

The causes of dizziness / 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 symptoms suggest that this can be due to internal ear disease.

MS and spine disease can be contributory to the vestibular (internal ear) disease.

Acute dizziness and vertigo is usually managed with;

1) vestibular suppressants,
2) antiviral medication,
3) antiemetic medications
4) steroids

Vestibular rehabilitation can help which is an exercise program. Please read this resource for the exercises;

http://emedicine.medscape.com/article/883878-overview#showall

Exercises are graded in difficulty based on velocity of head and object motion and by progression of body positioning from sitting to standing to walking. The exercises are graded in difficulty by narrowing the base of support, making the surface uneven, or changing the surface from firm to soft. Varied walking exercises are graded in difficulty by changing direction, requiring performance with the eyes closed, increasing speed of ambulation, walking on soft surfaces, or navigating stairs. An aerobic exercise home program progressively increasing the time, speed, or distance that the patient could tolerate also can be initiated. But all of these may need supervision of a doctor if vertigo is severe.

Please feel free for your follow up questions.

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

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Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 36,108
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
Verified
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