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I am struggling with balance issues which is causing anxiety…

Customer Question
Hi I am struggling...

Hi I am struggling with balance issues which is causing anxiety one doctor 2 months ago said it was labaryntinis and a second doctor said it was vertigo and did a manoveour a couple of days ago which has not helped with the balance but has fixed the nausea

Doctor's Assistant: Have you seen a doctor about this yet? What medications are you taking?

Yes I have seen 2 doctors only blood pressure medication and magnesium and calming herb along with a probiotic

Doctor's Assistant: In general, how has your health been lately?

I suffer from allergies and ibs and habe had terrible anxiety

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I have vonwillerbrands as well

Submitted: 1 month ago.Category: Neurology
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Answered in 1 minute by:
12/27/2017
Neurologist: drphophalia, Other replied 1 month ago
drphophalia
Category: Neurology
Satisfied Customers: 37,188
Experience: Regularly deal with musculoskeletal neurology, spinal issues, bowel and bladder dysfunctions etc.
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Neurologist: drphophalia, Other replied 1 month ago

Hello Jackie,

What is your age?

What are the investigations done for balance issues?

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Customer reply replied 1 month ago
50
No investigations one doctor said it was labaryntinis and the other said vertigo
Customer reply replied 1 month ago
The Nausea has settled but the balance hasn't which is causing me to have terrible anxiety
Neurologist: drphophalia, Other replied 1 month ago

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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Neurologist: drphophalia, Other replied 1 month ago

Imbalance 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.

The causes of dizziness (which is more than imbalance and there may be rotation of the self or surrounding) 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 doctor may consider MRI or CT scan for brain and ears for the evaluation. MRI with gadolinium enhancement is particularly useful in detecting smaller intracanalicular tumors such as acoustic neuromas. Chronic dizziness 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.

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. 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, 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

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Customer reply replied 1 month ago
Do you think a chriopractor would.help.as I think some of.it is caused by my severe.anxiety I have tried all types.of treatment to.control.my anxiety but have not been successful if you have high anxiety can it cause you to.feel.of balance and nauseaus
Neurologist: drphophalia, Other replied 1 month ago

Sure. Anxiety is known to cause imbalance and nausea.

Anxiety can be treated by the following measures by yourself;

1) Cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT); done by a psychologist.

2) Relaxation training and biofeedback.

3) Hypnosis

4) Acupuncture and acupressure

5) Yoga

6) Meditation

7) Group sporting activities

8) St. John's wort

9) Melatonin
10) Valerian root.

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Customer reply replied 1 month ago
Thanks for you reply I am taking magnesium as was told may help with anxiety along with a probiotic for my ibs as some of my anxiety is brought on by my health i will try some of the things you have suggested are the above supplements ok to take
Neurologist: drphophalia, Other replied 1 month ago

You are very welcome.

You can take Magnesium and Probiotics. Both are good.

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