Going on 8 months of constant problems

[alias19]

Hello,
I am a seemingly healthy 28 year old man. On August 15th of last year I started experiencing dizziness. This, and I can't be more emphatic about this, has been constant ever since. It is not room spinning, the best way I can describe it is it feels like I'm wearing a glasses prescription that is slightly off. When this first started occurring I was unable to leave my house. Upon going to a general practice doctor he said, "it's probably an ear infection" and gave me antibiotics. These did not work. Weeks went by without my condition improving. Also during this time I would have occasional numbness spreading from my neck through my head and to my forehead. One day I felt so bad I went to the emergency room and they did a bloodwork and a ct of my head which both came back fine. I then went to an ear specialist who dismissed the numbness and said he believed I had a condition called BPPV. I was given exercises to fix the problem. They did nothing. After looking into it I saw that BPPV is a condition that occurs for a few seconds at different times. I again explained to the DR. that it was not temporary, it is constant from waking to sleeping. Around this time I was rubbing my upper neck as it was quite tense, and the right side of my neck where the spine meets the head swelled about two inches. I have for years suffered from bruxism which has led to a lot of tension in my neck and back. I explained this to the ear doctor, who dismissed it and ordered more audio tests which also came back fine. He then ordered an MRI on my brain. Again, everything was fine. I then went to a neurologist. By this point the numbness was almost constant and the dizziness would get better or worse based on how bad my neck was. The Neurologist said I was just stressed by the dizziness and said she believed I had Labyrinthitis. She sent me to a physical therapist who was an expert at treating labyrinthitis. She also sent me to another pt for neck spasms. After a lot of treatment for Labyrinthitis the PT decided she didn't believe I had it. The PT for my neck was helpful and the numbness decreased for a few days after each appointment. However, it never went away and the pt(which my insurance does not cover) had led me to over $1000 in bills for PT alone. So, I had to stop. She recommended I start going to a gym and try strengthening my neck and back. I have. I also went back to my Neurologist and finally convinced her to take an MRI of my neck and back. The MRI showed that a have a few bulging discs but not bulging enough that it is out of the ordinary. It also showed on my MRI that my back and neck were in extreme spasm. Her recommendation was a pain specialist. He recommended a steroid injection into the spine in the area of the bulging discs. This was done. It had no affect. In the mean time I have had my eyes checked, seen accupuncturists, chiropractors, and counselors who have put me on anti-anxiety medication to try to calm my back issues. None of these have really helped. Now, when I wake up the numbness will start within an hour of waking and still leaves me slightly dizzy and it almost feels like a numb pressure on my eyelids. I have a feeling that this has nothing to do with the bulging disc. The worse the bruxism is the worse I feel. This affects everything I do. I am simply miserable and can't really take much more emotionally. If you have any advice or comments it would be greatly appreciated. Thanks

erin matthew haines

[drgeroulis]

First of all, I'm sorry to hear about your situation and I understand the frustration of having these symptoms.
Dizziness as a complaint (non-vertiginous as you describe) and as you're likely becoming familiar with, covers quite a bit of the neuro-otologic pathways and can therefore be difficult at times to reach a diagnosis. I'm assuming your neurologic and otologic exams were normal? (do you distinctly remember being told you had NO pathologic nystagmus and normal vestibular ocular reflexes or VOR's?) Also were you checked with Frenzel lenses? (do you remember wearing funny looking goggles either by the neurologist or ENT doc? What was the extent of the ENT evaluation? Labyrinthitis is usually viral (at least we think it is, however no virus has been isolated as far as I know)

Do you have headaches?
Have you required a bite fitting for the bruxism?
Tell me more about the bruxism. Do u have sleep problems, sleep apnea etc
Has your thyroid been checked?
Any other health problems in the remote or current past that you havent mentioned? Recent vaccinations?
Is your gait affected? Balance ok?

[alias19]

I have taken ocular test and worn the biggoggles, they turned out fine. My Neurological exams were fine too. The ENT
exams, included looking in my ears, eyes, throat, and audio testing. I do
not experience Headaches. I do wear a mouth guard at night. My sleep is
mediocre at best. Usually about 5 to 6 hours. My thyroid to my knowledge
hasn't been checked. No other recent health concerns. My balance is fine.
It was worse but has gradually gotten better. However, when the dizziness
gets bad I do have to sit down.

[drgeroulis]

I have a few thoughts for you. If this were a vestibular neuritis, and you are trending in a better direction in regards to your symptoms, then it is not surprising it is lasting for many months. However, putting together your neck problems, bruxism, dizziness, possible musculoskeletal problems, your symptoms may be more multifactorial. There is a rare version of headaches called vestibular migraines, and may not necessarily have much of an actual headache component to them. I cannot say whether this is what you suffer from, as our exchange of information on this forum obviously cannot include a comprehensive evaluation into your problem. I can tell you what I've seen and done in my experience thus far. I've had success with trigger point injections, especially with people that suffer from neck problems with headaches and dizziness. Not all physicians do these procedures, and depending on the physicians training (mine was more procedurally based in terms of pain management) you may or may not find a neurologist that does them. My guess is you will. Other options/approaches to treatment, would be treating with headache prophylactic medications regardless of whether youre having headaches or not, and which can help with neck problems as well. Also, some people fall into a wastebasket category of just being plain dizzy with no apparent cause. For these people, medications that help suppress the vestibular system/ or muscle relaxants can help. Your physician can discuss these options and others if your symptoms dont continue to improve. A touch of time and good sleeping, eating and overall health habits can sometimes make enough difference to make this tolerable and better. I hope things get better for you.
Take care.