What to do about dizziness?

[Fluffysmom]

I've noticed that a lot of us deal with dizziness/vertigo.  I'm wondering if I should do something more about mine.

Yesterday at physical therapy, my PT worked on my neck, which increased my dizziness somewhat, though not as bad as in the past.  She then took me to the gym to try a new exercise to strengthen my gluts, saying that I needed a strong platform in order to keep my neck from being so constantly rigid, tight, guarded, whatever she called it.

She had me stand on a box, put my weight on one leg, and reach behind me with my other leg, tap the floor, bring the foot up without touching the box, and repeating 10 times.  By #9 on the second leg, I totally lost my balance, fell sideways off the box, landed on my left leg (tweaked my bad knee), stumbled across the gym sidestepping until I wrapped both arms around the front of an exercise bicycle.

My wee PT tried to catch me, but I was falling and stumbling; at first she thought I was joking around, she said.  Then she was horrified, and glad that I didn't hurt myself.

My knee now yelps at me with normal walking (my ACL{second replacement} is already loose and thinning), and doesn't help with balance issues any.

My question is what can I do about my dizziness?

A few years ago my otolaryngologist said that he could do a test to see if I had BBPV, but that would just show if moving me around caused my vertigo to be worse.  He gave me some low-dose Xanax to take, which helped very little, if any.  The last time I tried it, it actually seemed to make things worse.

He said that my dizziness was not from my allergies.

I called him after my brain MRI showed all those lesions, and asked if  my dizziness/vertigo could be caused my MS.  He hemmed and hawed, said it was possible, since some people with MS did experience dizziness, but it was difficult to say, since he's not a neurologist, yada yada.

Since we've had discussions here about peripheral as opposed to central vertigo, I'm wondering about tests such as a VNG or others I can't remember now.  None of my neuros have thought my dizziness extreme enough to be of any concern to them, but since it's messing with my life, I'm thinking that maybe I'll bring it up with a little more emphasis at my next appointment with my MS specialist next month.

Or do I see a new otolaryngologist?  Any ideas, suggestions?  

Thanks,

Kathy

[PastorDan]

Oh, I didn't mean to imply that it wouldn't help anyone.  It didn't help me at all, but I've heard from others that it often does.

[PastorDan]

Hmmm.   My ex neuro was a loser, and sent me to a PT who DID specialize in vestibular rehabilitation therapy.  Actually, he told me what kind of PT to find, and let me do the searching.  She really seemed to do all she could, but in reality, there was just no notable effect from four weeks of therapy.  I haven't seen the lesion that causes this, but I can't help believing it's in there somewhere, and has nothing to do with the vestibular system, but is making my brain think there's a vestibular imbalance of some kind.  It's like trying to take up bike riding to treat baldness, or changing the TV channel because you don't like the taste of your supper.

[jensequitur]

In my opinion, your PT should have evaluated you for balance and vertigo before she decided to give you that particular exercise!  That's just ridiculous.  Now your knee is injured on top of your other problems... sheesh.

There are PT exercises that can help you rehabilitate.  Vestibular something or other...  I think it involves retraining the brain so you can find your center.  However, your vertigo and your lack of balance are two different things.

MS can definitely cause vertigo.  I have a lesion in my cerebellum, which my neurologist thinks is causing my vertigo.  You can also lose proprioperception with a lesion in the spine.  Mine eventually went away, and nothing I tried worked...  just time, and patience.

My balance issues still remain.  If I close my eyes, I don't know which way is up.  I have to lean against the shower stall when I'm washing my hair so I don't fall over.  I don't know if they'll ever go away.  My neuro is a loser, and thinks that PT won't help my balance issues... so here I go to find another...  I've been saying that for four months, haven't I?

[essdipity]

I feel as if I invented the rocking boat. Move over, Noah.

This is my third bout of this kind of vertigo. When I'm sitting or lying down things are perfectly normal. When I get up and move, holy moley. Mostly side to side stuff, with the floor rocking' around the Christmas tree.

In about 2 weeks I have a VNG scheduled. I think this will show only whether or not the problem is peripheral. I don't think it can detect abnormalities in the CNS, so if my neuro doesn't believe me now (and who knows?), he's not likely to be convinced by a negative VNG.

However, Quix is our vertigo expert, so perhaps she'll join in here. She's had BPPV for quite a few years, and has been treated by the Dr. Epley who invented the technique named for him. BPPV is a peripheral issue only, so it's coincidental that Quix has this and MS as well.

ess

[Fluffysmom]

I'm on my third year of allergy shots.  The doc (Dr. W.) that sent me for them is the otolaryngologist that said the only testing he would do was for the BPPV.  I do my own shots, and recent testing shows that they're really helping.  

I'm not diagnosed with MS, my MS specialist hasn't thought much of my dizziness/vertigo.  I will ask her about a ENG/VNG when I see her next month.
The time I saw her with my worst symptoms, her chart notes didn't reflect that I had any abnormalities in my exam except for my tremors in my upper extremities.

I almost fell when trying to walk on my toes, walking heel to toe, etc.  I figure she just filled out my template at the end of the day and didn't remember anything about my exam except the tremors.  My reflexes were more pronounced than usual, etc.  

That day she told me that my symptoms were coming from my cervical spine, but were not outstanding enough to call for a new spinal MRI until spring.  Well, it's Spring!  

At my next visit, she came up with a theory that is sending me to see my cardiologist from 2003 to have him review my records and hopefully tear apart her theory that my PCP thinks is full of holes.

As for a vestibular PT, it's difficult to find a PT that can work with my multiple physical issues without hurting me, so I'll have to research carefully to make sure a new PT understands multiple issues.  Maybe I should have the ENG/VNG done first.

Another dizzy day here... and I'm going out to dinner with friends of a friend that I don't know very well.  A challenging but fun evening, I'm sure!  

Kathy

[Nancy T]

Kathy, haven't you had an ENG/VNG yet? If you have an ongoing problem with dizziness, I'm kind of surprised. On the other hand, if you are diagnosed with MS, I suppose they would want to ascribe your dizziness to MS. But it's possible to have MS AND inner-ear trouble too, I'm sure.

What might be most helpful, from a practical standpoint, is to find a PT who SPECIALIZES in vestibular therapy. Check the Vestibular Disorders Assoc. search feature.

At least one neuro-otologist in this area DOES believe that allergies exacerbate dizziness that is due to inner-ear problems--he even provides allergy shots in his office. I did this for two years (even though I would never have guessed I had allergies, but their testing said I did). It may have helped--but, as always, the dizziness gets worse again. Better, worse, better, worse, better, worse...

Nancy