Vertigo While Sleeping...

[ImSimplyMe]

Hello everyone. I want to start by saying that I was diagnosed with Meniere's disease when I was about 13 years old. It was never more than slight ringing in the right ear, some low range hearing loss and occassional lightheadedness when standing up too quickly.

It is now 14 years later and two months ago I was sitting in my living room when I got the most severe case of vertigo. I ended up throwing up all of my dinner, which I assumed was the cause (food poisoning) so I let it subsided (lasted about an hour) and forgot about it. I had two more episodes over the next two weeks, one which prompted a visit to the ER. They did a CT scan, blood tests, urinalysis, EKG and said that from a medical standpoint everything was perfectly normal and that I should check with my ENT. I did this, and was told that I either had a flare up of Meniere's or MAYBE it was labrinthitis. Did a hearing test - no significant changes in 14 years. All he wanted to do was prescsribe me Valium and have me sleep through any future attacks. This was not acceptable to me. I was even sent to the eye doctor for evaluation (to see if it was related to vision problems) and he said everything looked great.

I found that certain things aggrivate it...working on the computer, knitting, and anything that requires concentration. I have been without an attack in almost 2 months, but I have recurring bouts of nausea. I took a pregnancy test to be sure, and this is negative as well.

For the past three nights, I have woke up to a feeling of nausea and slight vertigo (just enough to be uncomfortable). The feeling lasts about 5 minutes, and accompanies feelings of flushing and the need to go diahrrea. It passes as gas and then I feel better. Strange, I know.

Does anyone have any comments, suggestions or anything to help explain what's going on. My husband, who is a chiropractor, has been an angel in keeping me well aligned. It seems as if this helps a great deal in preventing attacks, however, I'm finding that night time seems to trigger something. I cannot figure out what it is.

Please, I'm just looking for answers and the medical community seems to have left me in the dark on this one. Thank you.

[realitystate]

I don't experience the nausea but i have everything else. I feel strange walking down the street sometimes and i noticed it makes me uncomfortable to stand still because i feel like i start to sway from side to side like a leaf. I feel like my perception of depth is off. My symptoms are most similar to vertical heterophoria syndrom. Is that treatment very expensive?

[Enoch Choi, MD]

I left a message for Dr. Debby...  Thanks for asking her to help!

[missmellie]

the vertigo is caused by the inner ear labyrinth something like that,my husband had an attack of this 5 years ago, he had nistagmus the eye moves from side to side, something which i recognised becaseu my sister has had this since birth.   my husband got terrribly dizzy and started vomiting, i rushed him to the doctor and he was admitted becasue he's a vet and they wanted to keep a check on him, his blood pressure was low. the doctor confirmed that it ws laby whatever and said it is a virus of the inner ear, and that he could have attack of it in the future as it stays there, anyways i don't think that it is something that you should get worried about, just be better informed so when it does happen again and  that is a postive IF, you will know what to expect and know of choices of how to treat it ggod luck

[lognum]

Thanks and I wish the same to you. I had just come back from a "tune-up" with Dr. Debby, in Michigan and had mentioned the possibility of you contacting her. It is certainly, pardon the pun, an eye opening experience. All the best!

Maurice

[Enoch Choi, MD]

Happy New Year!

[lognum]

Dr. Debbie Feinberg  248-258-9000, the rest is up to your discretion. She is always willing to help.
Seasons Greetings

Maurice

[Enoch Choi, MD]

how do i contact dr. feinberg?  would dr. feinberg like to document some findings here at medhelp?  it could help many folks, like the ones you've helped.

[lognum]

Greetings Dr. Choi

I respectfully request you contact Dr. Feinberg at the "vision specialists of Birmingham" MI site. The condition has been in the journals since the 1800's, but no-one, till recent years, has connected the dots. She is perfectly willing to speak with medical professionals, as yourself. Actually, her colleague, Dr. Akira Tajiri is located in Reedley Calif.. The hinderence to a more public knowledge of such findings, appears to be the lack of "willingness" on the part of the medical professionals, to speak to each other about similar patient symptoms. Hopefully that corner is being turned. Both ENT specialists and Neurologists in the Michigan area are now referring some of their patients to her.

Best Regards,

Maurice (aka lognum)

[Enoch Choi, MD]

I see that diagnosis associated with 2008 ICD-9-CM Diagnosis 378.44 but I can't find much about that diagnosis being associated with vertigo.  Is there another medical term for this condition?

I appreciate you pointing it out to so many forum users that complain of vertigo.

[lognum]

Greetings,

You had mentioned you get bothered by doing computer work and knittng. I would say it is close up activities that bother you and not situations that require concentration ( your eyes). The trouble with symptoms is the cause and it is hard to filter through what actually "is" the cause. Your bathroom episodes are beause of the slight anxiety you are experiencing after the vertigo and the fight or flight reflex triggers your bathroom visit. You had said you went to a vision specialist, so did I, but you may not have gone to the right one, of which there are only three in the USA. I travelled from Canada to visit one. The only person that could help. I had been to ENT, Gastroenterologists, Neurologists, Allergists, had MRI, CT scan, blood work and ENG, all negative. Try typing into a search engine, "vertical heterophoria syndrome". The Birmingham, MI, specialists are the ones' that helped me. Remember, it is the "syndrome" part that is important. Yes, your optometrist may advise they know of vertical heterophoria, but I can guarantee they do not understand the diagnoses of the "syndrome". Check out the testimonials and the symptoms and see if it describes you. Trust your instincts. No meds and no surgery and I am 100% more functional. Good Luck.
p.s. I refused to take any of the meds suggested by the doctors I had been to and I was right.

[Enoch Choi, MD]

http://www.medhelp.org/private_messages/new?recipient_id=242516
did you try that link?

[Enoch Choi, MD]

sorry, didn't get your message.

cindy's pretty busy today, but i'll ask her to contact you

perhaps send the message again? maybe it got lost in the morass of electronic bits...

would have loved to come in feb, maybe in the summer...

[Wear/a/Jimmy]

Dr. Choi,

I tried to send you a private message, but apparently it did not work. Cindi e-mailed me some time back, and I sent a positive reply back to her. But I have not heard from her since?

Regarding Phuket, just let me know when you are going to be here, I may make a trip to Phuket to meet you. I go there quaterly to for work related things.

[Enoch Choi, MD]

Wear/a/Jimmy is right, the internal auditory canal needs an MRI with gad to see problems.

[Wear/a/Jimmy]

One more point, if you do get an MRI, make sure they use gadolinium....  with and without contrast is the term used.

Sometimes an MRI is ordered, but there is not a comparitive study done, no gadolinium applied, and basically you the patient, just wasted a lot of time and money on that MRI.


google: gadolinium IAC MRI protocol

for more information

I aslo think than an MRI is a good idea, but then again I like to have one for my own well being. Kind of like to have one for comparison studies down the road etc.

[Enoch Choi, MD]

OtoHNS_MD is right, i'd get an MRI of the internal auditory canal.

A second opinion from a university tertiary care facility isn't a bad idea...

[Wear/a/Jimmy]

Meniere's can be a difficult diagnosis.  A good single diagnostic test does not exist.

Yep, the funny thing is, I have seen it diagnosed hundreds of times on initial visits.  

[OtoHNS_MD]

Meniere's can be a difficult diagnosis.  A good single diagnostic test does not exist.  You sound like you have some features of the disease.  Do you have a family history of Meniere's?  Have you had an MRI scan of your brain/internal ear canals?  Do you have any migraines or headaches?  For Meniere's, some of the 1st line, simpler treatments include a low salt (1500mg/day) diet and a blood pressure medication called Dyazide.  There are a whole host of other treatments including surgeries, but these are somewhat controversial and typically reserved for severe cases.  

[Wear/a/Jimmy]

OK

Theory here:

1) Sudden onset vertigo, like the time you vommited dinner...  is unique to mynieres (sp)

2) Mynieres means there is a peripheral disorder, menaing a disorder located within the inner ear, specifically within the SCC (SEMI CICURLAR CANALS)

3) The balance system is extremely complex, if not too complex for my wee little brain to get a handle on. But in summary, the balance system is comprised of 3 in puts. Vision, Vestibular (ears/SSC) & Somatasensory. (sp) Somatasensory just means touch feel etc. The body has sensors located within in our leg muscles feet etc. that send information to the brain. This is how we know how to react to inclines, declines, stepping on stairs etc.

OK so we have 3 systems
1) Vission
2) SCC
3) Somatasensory

If one of the 3 are compromised, damaged, weakend etc, the body will compensate and utilize the otehr 2 systems. (see I told you it is complex)

Now, this is the theory part. You get up at night to go to the bathroom...  and you spin like crazy. What I am thinking is,.....  you are spining because it is dark. Remember your SCC is already weakened due to myniers, now you have to rely more heavily on vission and somatasensory input. But when it is dark, vision input is less or zero, so now you have to rely on somatasensory....   The balance system is like a 3 leg stool, and at night, you have to function on 1 leg, the somatasensory... which makes it all the more difficult.

So that is my theory.  I don't think diarhea has one bit of relation, just guilt by association, and that may have been what woke you up in the first place.

If your husband rotates your head in certain ways... this can induce BPPV. Benign Proxisiminal Vertigo. I will let you google that on your own.

My advice, let him do that to others....