vagus nerve question

[troublebunny]

Hello!
Last April, out of the blue, my husband (44 and in good health) began experiencing bouts of severe lightheadedness. The bouts are accompanied by indigestion, problems regulating his temperature, and often pain in his chest to the left of his sternum between his pectoral muscle and his shoulder. At first, the onset of these symptoms was also followed by a pounding heart.

Fearing heart trouble (which runs in his family), he has had EKGs, chest X-rays, blood work and a cardio stress test...his heart checks out fine. In home monitoring, his blood pressure is normal and his resting heart rate is low.

He has also been evaluated for inner ear issues (meniere's, etc) and been given a clean bill of health. Based on all of that, the doctors have said they believe he is suffering from migraine equivalent, and that the pounding heart was due to a panic response brought on by the sudden lightheadedness.

He has made some dietary changes and increased his exercise level (regular exercise seems to lessen the severity of the condition), but, nearly a year later, he is still experiencing the symptoms every day (except for the pounding heart, which only happens occasionally) .

So here is my question: could this set of symptoms indicate an injury, inflammation or compression of the vagus nerve? Years ago, he dislocated his left shoulder while snowboarding, and it still gives him trouble. He also tends to store stress and tension in his back, neck and beneath his shoulder blades, getting severe knots from time to time in those areas. Before the initial onset of his symptoms, we had moved all of the furniture out of out house and back in (refinishing the floors) and he had also been working on some ceiling repairs, with his arms above his head for long stretches of time.

If the vagus nerve is a possible culprit, can anyone tell me how it can be tested? Also, are there non-surgical means of relieving the symptoms (massage, acupuncture, acupressure, etc)?

Any info would be greatly appreciated. This condition is seriously impacting his quality of life!

Thank you!

PS: To be clear: his lightheadedness is not accompanied by the spinning sensation of vertigo. He describes it as the kind of lightheaded detachment from surroundings one gets from breathing in chemical fumes.

[Dr. A. Srivastava]

Thank you for your question. Dehydration may occur with any of the medical condition and vagus nerve effect can be increased by that. Please consult your doctor who will further evaluate the possibilities here. Hope this helps.

[troublebunny]

Thank you for your response, Dr. This information is very helpful. I'm curious to know why you mention dehydration. As far as we know, my husband is not dehydrated. Was there something in the symptoms I listed that indicated dehydration to you?

Also, can you describe the process a neurologist would use to evaluate his vagus nerve function?

Again, thank you for taking the time to respond. I appreciate the help very much.

[Dr. A. Srivastava]

Thank you for your question. Although without being able to examine him I can not offer you the specific advice on diagnosis and treatment that he needs, but I would try to provide you some relevant information about his health concern.

Vagus nerve supplies in many major organs like heart, lungs, stomach, palate, esophagus etc. Therefore, vague nerve damage can cause bradycardia( decreases heart rate) ,arrhythmia,  voice changes, difficulty in swallowing, gag reflex, constipation and incontinence but its damage does not cause dehydration. However, vagus nerve effect can be amplified by dehydration (though dehydration may originate due to any gastrointestinal illness through vomiting or diarrhea etc.). In addition, vagus nerve stimulation by dehydration can lead to decrease in heart rate/pressure and then fainting. Therefore, only his neurologist can be precise here after examining him. If it is a vagus nerve damage then nerve stimulation and blocking therapy can be two forms of treatments available and they can be utilized as per the requirement of the case. Surgical option (vagotomy) can be kept reserved in severe cases. Hope this helps.