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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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44 yo male. is technically deaf due to mother having measles

Customer Question

44 yo male. is technically deaf due to mother having measles during pregnancy. functions normally with hearing aids both ears. Reads lips. has had migraine headaches for years. Suffers from sinus infections intermittently. Week ago started experiencing dizziness. Went to general doc. Given rxs for sinus infection. 4 days ago became so dizzy could not walk wihtout help or drive. Went to ER this morning. Had MRI of brain. Clear. Was told sinus infection gone. Take no more sinus meds. Given high dose of prednisone (3 [pills per day) and referred to neurologist with possible diagnosis of vestibular neuritis. Bouts of laughing and crying just come on for no reason. he doesnt know why? At ER when testing eyes with light something about fluttering when he looks up. ER doc says that is one of the rasons he is being referred to neurologist. Today is Feb 23. Cannot get appt with Neuro until 3/3. This man is sick. What do we need to do?
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello. welcome to JA. the bouts of crying/laughing inappropriately suggests the diagnosis of pseudobulbar palsy (PBA). It also sounds like he has Parinaud's Syndrome or nystagmus retractorius??? Or the eye movements could be vertical nystagmus. That in the setting of feeling dizzy could suggest a brainstem stroke or infection, especially with the PBA finding, if that started recently as well. He needs an MRI scan of the brain, with and without gadolinium (contrast) with attention to his midbrain, inferior frontal lobe region. THis could be a type of stroke, or a tumor, or an infection. Cannot say more from here, I would need some neurological examination information. Can he walk unaided? Is he ataxic (falling from side to side)? Please get back to me to discuss this further, and I will reply. Dr frank