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Dizziness, foggy head, imbalance with neck pain.

Resolved Question:

Hi
I've been suffering with dizziness/foggy head/imbalance since March 2014 and no one has been able to help (I only got stress as a diagnosis). In Feb 2015 I started getting neck pain and last week I started feeling shaking in my arms along with facial numbness. The pain in my neck is usually on the top area (at the start of my neck) and I often feel very sensitive between my eyebrows. Below is a summary of the tests I've done since March 2014:


Ear test:
No active nystagmus no change with turning to one side
-Examinations: ear is normal
March 2014 test : normal thrush test is normal cerebellar tests are normal

Blood tests:
TSH- (Thyroid Stimulating Hormone) result 1.81/mIU/L/reference range 0.35-4.94
CRP- Quantitative (C-Reactive Protein) result 0.7/mg/L/reference range less than 5
ESR- result 15/mm/1st.hr/reference range 0-11
FBC (full blood count) all normal and within range
Vitamin D- result 22.2/ng/ml insufficient

MRIs:
Brain MRI with contrast (May 2014)
- All normal except for Mild Left mastoiditis.
Neck MRI (June 2015)
Straightening of cervical lordosis denoting muscle spasm.
Mild diffuse disc bulge at C5-6 level abutting the anterior CSF space with no evidence of nerve root compression.
Mild diffuse disc bulge at C6-7 level abutting the anyerior CSF space.

Vision test: all normal

Would really appreciate if you can help me, feeling really down at the moment as I feel helpless.

Thanks,
Myriam


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hi,
Thank you for posting your query at DoctorSpring.com.
I have noted your symptoms and they are suggestive of peripheral vertigo. Central vertigo due to brain disease is unlikely in view of normal MRI of brain.
Peripheral vertigo are often due to ear and cervical spine involvement.
Treatment is mainly symptomatic and with exercises.
Medications such as betahistine tablets are used to prevent/treat dizziness.
Neck extension and vestibular adaptation exercises are done to provide long term relief.
I hope it helps.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Patient replied :

Thanks Dr.Kumar
I have been seeing an orthopedic regarding my neck pain however is there a specialist doctor I should be seeing regarding this peripheral vertigo? I am lost and not sure if I should be seeing a neurologist/orthopedic/ENT specialist/chiropractor...!


Expert:  Dr. Sudhir Kumar replied 3 Days.

Thank you for getting back.
Yes, seeing a specialist would be very helpful. Unfortunately, getting a vertigo specialist is not easy. They are referred to as neuro-otologists (either an ENT or Neurologist, trained in nerves related to ear and its connection to brain).
If not possible, you can see a neurologist and ENT separately (the second best option).
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Patient replied :

Hi doctor- I re-did the brain MRI since my last one was a year old. Attached is the report. Can you please let me know what the findings mean? Are my symptoms related to this finding? Thanks again


Expert:  Dr. Sudhir Kumar replied 2 Days.

Thank you for getting back.
I have noted the MRI report findings. The brain is within normal limits. Minor problems related to ENT are noted, however, they are not related to your current symptoms. You can consult an ENT doctor for medical treatment of the abnormalities.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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