Expert: Harriet B Jacobster, Au.D. - 3/22/2009

Question
For about three months now, I have been having dizzy spells. These can last from a few seconds to a full half hour, complete with a mind-numbing headache always in the same spot on the back of my head. These occur daily, though usually only the seconds-long variety and seem to be provoked by nothing in particular. It's like I feel this sudden tug or pulling sensation to the right inside my head and then it's almost as if I'm swimming or floating while everything else remains stationary. While there is no pain involved with these short spells, they are an inconvenience and can be scary if I'm driving. I have gone to two different ENTs and both have no explanation. I have gone through a Dix-Hallpike exam, diabetes testing, and an MRI and nothing has been strange. While I'm glad that I don't have diabetes or a brain tumor, finding nothing is very frustrating. What should I do?

Answer
Hi Sarah,

Dix-Hallpike is the test of choice for Benign Paroxysmal Positioning Vertigo (BPPV), vertigo that occurs with change in position.  Your symptoms are not suggestive of BPPV, therefore I am not surprised that the D-H was negative.

You need a complete vestibular workup which includes an auditory evaluation and a complete Nystagmography that includes caloric testing.  This is a test of the vestibular/balance portion of the inner ear.  An audiologist is the professional who performs this evaluation and, in all honesty, it should have been ordered by the ENT.

Here is a great website that will give you more information on this condition: vestibular.org. If neither of these ENTs will recommend this evaluation, you need to find one who will.  

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology