I am wondering if all these would mean I still have an active infection?
I hope you're able to get to to the bottom of it and that you get better soon.
@DAF, you must be an otolaryngologist. Your post is incredibly informative. It took me a while to digest it (brain not working too well at the moment, lol).
I'm not an otolaryngologist, I hold a clinical doctorate in Audiology and spent 21 of my 23 years in this field evaluating people for hearing and vestibular disorders. The vestibular system is soooo complex and there is so much misinformation out there. I'm passionate about what I do.
You may be right that the reason for my syncope was different from what I have now, but still wonder if the effects of the viral infection had already started to set in. I'd had the viral infection for over a week. I think possibly I was electrolyte-deficient too, having just worked out super hard that day and the day before, when my body was still weak from the viral infection.
Viruses can caused both hearing and vestibular losses. But, if you were physically weak and worked out too hard that could have caused you to pass out.
I'm convinced when I fell and hit my head, the impact caused a crystal, or part thereof, to be dislodged, thus causing the 200-300 mile p.h. room spinning sensation - it was sooo severe that I couldn't even sit up from the bed. The dizziness I have right now, have been suffering from for the last 3 months, is of a different nature. It is as if both my body is floating and the room is spinning (but nowhere as fast).
The head injury may have caused more than a crystal to dislodge, e.g., damage to another part of the vestibular system. The crystals are used by the gravity and acceleration sensing systems in our ears. The sensation of floating suggests something may be amiss with that system. VEMP is the test to determine the functioning of that system. BTW, there are two different kinds of VEMPs, cervical VEMP is the most commonly done, and it looks at the gravity sensing system (saccule and inferior vestibular nerve). The other, less commonly performed is ocular VEMP, which looks at the functioning of the utricle.
If one of the motion sensing balance canals has been affected, vertigo can occur with quick head movements. The brain analyzes information from the ears and loves status quo, e.g., equal input from each side. When one side doesn't report the same information as the other side, the brain perceives the sensation of spinning. Our brain does adapt to vestibular weakness, it usually takes eight to 12 weeks. Slower movements it can recalculate and correct for, fast movements, are, well, too fast for it to keep up and the result is vertigo.
My ENT says I don't have BPPV as my head is not titled. I've also been checked for nystagmus and appears I don't suffer from it. I am due for an appt with my chiropractor to do the Epley manoeuvre and some vestibular re-eduction but the ENT advised me not to. I'm still thinking about going..
Heads don't tilt when you have BPPV. The displaced crystal(s) move with head movement and settle once the head stops moving. How long does the spinning sensation last and is there a trigger? Epley treats posterior and anterior canal BPPV. There is a different maneuver for horizontal canal BPPV. Wouldn't recommend vestibular re-education until VNG, VEMP and ECoGH have been completed. You really need to find out what this is to effectively treat it.
I've had a hearing test but not the VEMP. My audiogram readings are between 30-40 dB, which I believe is borderline. There were no electrodes, just a headset. My ENT says my readings are "normal" and am a bit confused tbh.
Is your hearing loss flat, rising, sloping or high frequency? Those numbers are not normal, that is a mild loss. Meniere's typically presents with rising sensorineural loss (low frequency, bass, loss).
Actually, since I typed the above, thanks to YOU, I've found a place here that offers VNG, ECogH, and VEMP. I def think it's worth checking this place out. I can't believe this place has been here all along and I didn't even know about it, til now!! At least I'll know for sure whether I have Meniere's once I've done the ECogH .
http://www.novena-ent.com/giddiness-balance-assessments/
My recommendations have been based on your symptoms and what you reported that your physicians have said to you. If your vertigo is cyclical, then ECoGH may be a consideration. It is best done wihtin 48 hours of the onset of an attack. If your vertigo is with head movements, this might not be the right test.
The "cycle" that is associated with Meniere's, how long it is typically? I don't seem to go through cycles. Basically, i feel dizzy and my left ear is blocked almost all time time, ie. daily. When I have "attacks", the symptoms are amplified many folds!
The repetition of the cycle can be anywhere from several weeks to a month or two. Acute vertigo usually lasts a day or two, followed by feeling crappy as your system recovers. Then, it starts over again.
The tests I recommended would give your physician a comprehensive look at your ears.
Thank you soooo soooo much for posting.
@DAF,
Thank you so much again for responding, in detail. You are obviously an expert in this area bc you talk so eloquently on the subject. I've had to look up quite a few things in your posts, lol. In some way, I wish I could remain ignorant on this subject, tbh. Wish I'd never had reason to learn what I have about it (albeit only a fraction of what is obviously very much a vast field).
The BPPV, I misunderstood, lol. No, I don't get vertigo from any head movement or lying on one side or the other. There is no fast spinning sensation (only the one time when I was hospitalised) and no obvious trigger. I've been dizzy almost on a daily basis, from the time I get up to the time I go to bed (the only time I get total relief is when I sleep, at the risk of sounding morbid; and no, I am not going to do anything stupid incidentally). And when I say "dizzy", I mean the room is spinning a little, not fast; and I feel, as mentioned, like I am floating but the latter is not severe, not really very bad. The sensation is more that I feel like I am going to faint. And my dizziness worsens considerably in the presence of loud noises and at one time by a very strong cologne. I am now also super sensitive to light, and noises which are I'm sure are normal to other people; when they never used to bother me before.
The place I went to yesterday claims to offer VEMP and VNG, as well as the hearing test. But the hearing test I did yesterday was exactly the same as what I had before, ie. there were no electrodes, only a headset,so not a true ECogH. These are my hearing test results:
Test done on 17th Nov 2017:
24th Nov 2017:
26th January 2018:
The test readings yesterday are very similar to the above.
You're right. I am confused bc both ENT's have said my readings are normal, but they clearly veer towards "mild".
I am not convinced I have Meniere's bc I don't seem to go through cycles. My symptoms, on the whole, have become progressively worse. Today is the first day in a long time that I don't feel horrible horrible. I wonder if that's a temporary relief, bc I am on anti-inflammatories, anti-anxiety as well as steroids pills. I am,however, hoping and PRAYING that the ENT yesterday is/was right about my having TMD instead of an ear issue(s) per se.
If, God forbid, my symptoms don't continue to improve, I will definitely go back ad ask for the VEMP and VNG tests. The ENT yesterday declined to do those tests, saying I'll need to see how I fare these next few days first. I also have another appt at another hospital, which I will keep for the time being.
Thank you soooo soooo much again, @DAF. I'm very grateful.
ETA: Incidentally, since I've been checked for nystagmus and I don't seem to have it, would that indicate that i definitely do not suffer from BPPV?
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