Understanding Vestibular Dysfunction and Nystagmus: Seeking Clarity
I’m a 27-year-old female with a background of supraventricular tachycardia (SVT) and polycystic ovary syndrome (PCOS). Currently, I am taking Spironolactone at a dosage of 100mg. Recently, I was involved in a car accident which has led to persistent dizziness. I visited an injury clinic where they conducted a videonystagmography (VNG) test. My dizziness feels more like an internal sensation of rocking or spinning rather than a spinning world around me. It's not continual; instead, it typically occurs when I change head positions—sitting up, leaning over, or turning my head to look around. The results from the VNG revealed considerable issues in both peripheral and central vestibular functions: - The peripheral findings imply a diagnosis of Benign Paroxysmal Positional Vertigo (BPPV), noted through: - Horizontal nystagmus at 7°/sec and vertical nystagmus at 2°/sec during leftward motion testing. - Paroxysmal positional horizontal nystagmus when the left ear was positioned downward. - On the central side, the results suggest a potential central nervous system (CNS) lesion indicated by impaired pursuit movement. The report mentions that symmetrical impaired pursuit may indicate problems within the cerebellum, striate cortex, or brainstem, aligning with disorders affecting oculomotor function, and hints at the need to examine the visual cortex for issues. Before undergoing the VNG, I consulted an optometrist who identified both vertical and horizontal nystagmus. He observed that my left eye is positioned higher than the right and recommended steroid treatment to alleviate any inflammation that might be affecting my vision. He expressed concerns that this might relate to issues stemming from three herniated cervical discs and one bulging disc that could be exerting pressure. The clinic suggested that physical therapy focused on balance could alleviate some of my dizziness. However, I have experienced a noticeable decline in my vision after the accident, characterized by symptoms including crossed eyes, double vision, distorted views, and trailing images. Prior to the accident, I had sensed a gradual increase in dizziness and vision problems over the past year, but the collision has undoubtedly intensified these symptoms and introduced new complications. Although I have not yet seen a neurologist or undergone a brain MRI, I am beginning to think it might be essential to do so to exclude potential serious neurological conditions. Currently, the injury clinic is primarily recommending physical therapy for my recovery.
Answers (1)
6/23/2025, 4:11:08 PM
OpenHealth AI
It sounds like you're experiencing a complex situation with dizziness and vision changes, especially following your recent car accident. You have been diagnosed with both Benign Paroxysmal Positional Vertigo (BPPV) and potential central vestibular concerns, which can be related to significant issues given your history and recent symptoms. Here’s what you should consider going forward.
Key Points:
- You likely have BPPV, which is often treatable through specific movements.
- Your symptoms of vision changes and balance issues warrant further neurological evaluation.
- Physical therapy for balance could be beneficial, but be cautious given your worsening vision.
Explanation:
- BPPV: This condition causes brief episodes of dizziness related to changes in head position. It’s typically caused by tiny calcium crystals in your inner ear moving from their normal location.
- Central vestibular issues: The findings from your VNG suggest there could be some disturbances within the central nervous system that need to be clarified, particularly since you've noticed a decline in your vision and other concerning symptoms.
Next Steps:
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Prioritize Neurological Evaluation: Schedule an appointment with a neurologist as soon as possible. Discuss your history of dizziness, vision changes, and any other symptoms. Bring your VNG results and any previous medical findings. A brain MRI could help exclude serious conditions affecting your brain.
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Follow-Up on Vision Issues: Since you are experiencing worsening double vision and other visual disturbances, consult an ophthalmologist or neuro-ophthalmologist. They can assess the relationship between your eye problems and neurological function.
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Begin Physical Therapy: If you haven't started yet, consider beginning a physical therapy program focusing on balance and vestibular rehabilitation. Make sure to inform your physical therapist about your visual symptoms to tailor the exercises accordingly.
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Monitor Your Symptoms: Keep track of all the symptoms you’re experiencing—when they occur, their severity, and any triggers. This journal will be helpful for your healthcare providers to understand your condition better.
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Stay Informed about BPPV Treatments: If diagnosed with BPPV, treatments like the Epley maneuver can often relieve symptoms. Ask your doctor about this if you haven't already.
Reassurance:
It's completely understandable to feel overwhelmed by these symptoms and the complexity of your situation. Taking these steps will help you in gaining clarity about your health, and obtaining the appropriate treatment for the symptoms you're experiencing. Remember to advocate for yourself and seek timely medical attention to address your concerns. Please feel free to reach out if you have further questions or need more guidance as you progress.
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