Resolved question:
Since September last year I have had daily dizziness. This seems to get worse when I am seated for long periods but it is always there. I have also had a sore throat for the same period. Inflamed and red with occasional white spots. More recently the dizziness has gotten worse (it feels like I am moving) and I have short sharp pains on the top of my skull and was as pain below my ear and just behind my jaw. I have also had recent pressure across my forehead and around my eyes (sinus?) which feels doesn't hurt but increases my feeling of disorientation. I have a history of ankylosing spondylitis (diagnosed in Jan 14) but am taking no regular medication at this time. I also get aches and pain around my neck either side just below my lymph nodes. Recent blood tests including standard thyroid testing have been normal.
Submitted:
4 Days
Category:
ENT Specialist
Hello.
Thank you for using DoctorSpring.com. Firsty, I am extremely sorry for the delayed reply - it is an exception and generally replies are quicker.
I understand your concern. You are suffering from giddiness since last 10 months, which is worsening now. You also have holocranial(involving the entire head) headache.
Giddiness can be due to many reasons including high or low blood pressure, disease of the balance system of ear(sense organs of balance is located in the inner ear) or due to some condition related to brain etc. To treat it we should know the correct diagnosis. In order to come to a diagnosis, I need additional information-
-Do you have continuous giddiness or is it episodic?
-During the giddiness, do the surroundings move or you seem to be moving?
-Is the giddiness brought about or aggravated with turning of the head or lying down?
-Do you have any hearing loss or tinnitus(ringing in the ears)?
-Is the giddiness associated with any nausea or vomiting?
-Do you have any nose block or nasal discharge?
-Have you done any investigations including hearing test / blood test or any imaging scan?
Your symptoms are not suggestive of sinusitis. Based on available information most probable diagnosis will be migranous vertigo. However I need the additional information for a definitive opinion.
For time being, we can start Tab. Betahistine 16 mg, three times daily for 10 days in consult with your doctor.
Hope this helps for now. Please reply in the follow-up.
Best regards,
Dr. Sunil Jalan,
ENT specialist.
Dr Julan,
Thanks for your response. In answer to your questions:
-Do you have continuous giddiness or is it episodic? Continued light giddiness which intensifies during the day and goes away almost at night but continuous.
-During the giddiness, do the surroundings move or you seem to be moving? Its me moving
-Is the giddiness brought about or aggravated with turning of the head or lying down? When I move my head around in a wide circle this intensifies the dizziness. Doesnt seem noticable when lying down.
-Do you have any hearing loss or tinnitus(ringing in the ears)? No hearing loss, tinnitus a lot of the time especially at night before bed
-Is the giddiness associated with any nausea or vomiting? No never
-Do you have any nose block or nasal discharge? I have had a stuffy nose for some weeks but no discharge
-Have you done any investigations including hearing test / blood test or any imaging scan? No hearing test. I had an MRI to diagnose my ankylosing spondylitis this was of the full spine. I have had regular blood tests, told that I was slightly aneamic and low vitamin D. None of these have related to my current hearing dizziness however and no other anomilies identified.
Hello,
Most likely your diagnosis is migraneous vertigo. To rule out other pathology I will suggest you to do MRI Brain.
You can start following medication (this will be prophylactic medication for both headache and vertigo)
Tab. Flunerazine 10 mg once in night for 1 month.
Tab. Betahistine 16 mg three times daily for 10 days. Please discuss the same with your local Doctor.
Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA
Did you manage to review the phot of my throat which is constantly sore. Could this be connected?
Hello,
Thank you for writing to us again.
I sincerely apologize for the delay in reply.
I have seen picture of your throat, very clear picture and all the structure are normal only. On posterior pharyngeal wall we can see some prominent blood vessels, but it is not congested. On left side of tonsil we can see some white spot, this is due to food debris stuck in tonsillar crepts, this is also normal and usually doesn't cause any symptoms except in few people it may cause some smell or bad breath(halitosis).
your sore throat may be due to tendancy to get recurrent infection, which can happen with change of season. you can do warm saline gargle when sore throat is mild.if it is severe than we need to start medication for same.
Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA