Expert: Harriet B Jacobster, Au.D. - 6/29/2009

Question
QUESTION: Hello. It is nice to meet you. I am so hoping you can help me. I am worried about my daughter.
She is 26. She has Pervasive Developmental Disorder and lives at home. (that isn't the problem)
Back a few months ago, I think it was in early April, she had fluid in her ear and it turned into an ear inflection. They gave her Amoxil and at the 2 week checkup it was still there. The infection and fluid.
So they gave her Amoxil. Later at the next 2 week checkup,
she still had fluid but not the infection. They suggested OTC Sudafed to clear up the fluid. Approx a week or so after that she started getting dizzy. So we stopped the sudafed. But the dizziness did not go away. So a couple weeks after that we saw an ENT. He did a test called ENG. It was normal.
We can't get into see a neurologist till Aug 27! Do you have any idea what is going on? Here it is almost the end of June and she is still dizzy. Although it comes and goes at random, moving her head and hot weather make it worse.
She has a slight ringing in her ears but that has gotten better with TMJ therapy.
Do you have any idea at all what the problem could be? Between now and August?
I'd appreciate any help.
Thanks.
Joyce

ANSWER: Hi Joyce,
Is your daughter on any other medications?  It is possible that the Sudafed caused a reaction when combined with another medication.  

It is also possible that your daughter has either labyrinthitis or vestibular neuritis, not uncommon after an upper respiratory or ear infection.  In labyrinthitis, the balance portion of the inner ear becomes inflammed with the original virus/bacterium, whereas in neuritis, it is the vestibular nerve that is inflammed. Both of these usually clear up with time.

Not all causes of dizziness show are uncovered in an ENG. Unfortunately, most of the time, figuring out the true cause of dizziness is more a case of elimination.  But you are definitely taking the right step by consulting a neurologist.  In the meantime, I will refer you to this site of the Vestibular Disorders Association: http://vestibular.org/

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



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

QUESTION: HI. And thanks for getting back to me so quickly. If this dizziness were a reaction to the meds, or the other w things you menitoned, wouldn't it have gone away by this time? I know it was April 19 when the Sudafed was suggested. It wasn't long, maybe a few days or a week after we started Sudafed that she got dizzy. So we stopped the Sudafed on the same day as she was seen. So even if it were any of those things, how long does it take to clear up? Its been over 2 months.
I wish we could get into the neurologist sooner but Aug 27 was the best they had.

Answer
Hi Joyce,
Without knowing more about the medications your daughter may have taken, or more about her history, I really cannot answer this.  I can tell you that some medications can have a permanent effect on the auditory/vestibular system.  Some cases of labyrinthitis or vestibular neuritis can take take up to six months to resolve; I have even known some patients that still had residual symptoms after a year or more.

As I said, at this point, the best thing is to consult the neurologist.  Perhaps you can call everyday to see if s/he has a cancellation and can then take you earlier.

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