Expert: Harriet B Jacobster, Au.D. - 3/11/2009

Question
QUESTION: Hi
On january 13,09 i suddenly had a dizzy spell, that resulted in vomiting, and loss of balance.  i thought it was a bug and felt better by the next day.  Then about a week later i felt a spinning sensation again not as bad as first but enought to scare me.  i went to a doctor and he told me i had a viral infection.  then a few days after i felt dizzy again so i went to a local clinic where i was told it was vertigo/labrynthitis due to a viral virus. I was given SERC 16mg.   ON feb 1 around 3 am i  awoke to a rushing sound in my right ear and when i moved my head i felt the dizzyness again, and was able to crawl to bathroom and vomited. that episode lasted a good day.  I made an appt with an ENT and was told that it was a viral thing (he didnt look in my ears) and told me to continue meds but was surprised when i said the attacks made me miss work but did ask further question.  i made another appt with another ENT and was told it was not labrynthitis but eczema in my ears and was given drops!  I am truly scared i have different comebacks from different doctors.  I recently went back to clinic after a minor attack and he gave me a referal to a neurologist.  that appt the neuro told me it was probably menieres' disease and i would loose my hearing in my ear, he also after i requested it gave me a referal for a CT scan to rule out anything  I am depressed, feel isolated, and dont understand what is going on with me  If the first doctor would have checked things out could i have maybe had treatement   plzzzzz help me

ANSWER: Hi Wendy,
I can certainly understand your confusion and depression.  

There are many causes of vertigo and one of them is viral labyrinthitis (VL). VL is not uncommon and usually occurs after an upper respiratory infection.  The diagnoses of VL is usually made by symptomology and history.  VL usually resolves on its own; however it can take up to several months.  

Meniere's disease (MD) has very specific symptoms: vertigo accompanied by low-frequency fluctuating hearing loss, roaring tinnitus, and a feeling of aural fullness.  Without at least three of these symptoms, the diagnosis of Meniere's is speculative.  Too many people use MD as a catch-all diagnosis for anyone experiencing dizziness.  MD can lead to a permanent loss, but it can also subside as quickly as it came with no lingering after effects.  

Now, I have never heard of eczema being the cause of such violent attacks.  

I am going to refer you to this site:  vestibular.org.  It is the website of the Vestibular Disorders Association.  On this site, you will find a wealth of information as well as a health professional close to you who specializes in vestibular disorders.  You should seek consult from a neuro-otologist preferably, and have your hearing and balance systems assessed by an audiologist.  Some of the tests you should have are: Basic audiometry and middle ear evaluation, Otoacoustic emissions, Nystagmography (with either electrodes or goggles) and Electrocochleography.  The last test is most sensitive to MD.  And you should also have an MRI with contrast to rule out a vestibular schwannoma - a benign growth on the vestibular nerve.

It is scary, I know...but in the hands of the proper professional, you will find your answers and proper treatment.

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



---------- FOLLOW-UP ----------

QUESTION: Thank you sooo much for a quick response.  I have had the vertigo, extreme dizzyness,cold sweat that did have a rushing possible roaring sound in my ear, which is how i knew something was happening  that happened twice  jan 13 and feb 1  as for te aural fullness and low frequency fluctuating hearing loss, I am not sure what these are  during the spells  i did have the swooshing sound  but i have noticed that i find my ears are either itchy or have a dull ache to them at times.   the less frequent spells didnt have any noise, just a dizzy feeling  Please get back to me on the explanation of  the low frequency and aural fulness of what this is exactly  
thank you again soo much  I finally feel like there is hope or atleast someone is listening and offering some help

Answer
Hi Wendy,

Aural fullness feels like your ears are stuffed with cotton or even like your ears are going to explode...something like a cold.  This is very typical of Meniere's.  The feeling comes from an overproduction of fluid in the inner ear pressing against its hard bony shell.  The low frequency hearing loss may not be as noticeable, but, again, it's a similar feeling to having a cold and having stuffy ears.  Some people describe an attack as having a "cloud over their ears."  Once the attack subsides, the "cloud" lifts and hearing returns to normal, or near-normal.

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