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Should I Seek a Referral to Neurology?

7/5/2025, 3:10:26 AMMale25-34

Hello everyone! I’m a 32-year-old female and I recently attended an appointment with an audiologist due to experiencing episodes of muffled hearing two to three times daily. During my evaluation, they made an interesting observation: episodes of pure torsional nystagmus were detected. This type of nystagmus, without an upbeat direction, burst component, or accompanying feelings of dizziness, does not align with Benign Paroxysmal Positional Vertigo (BPPV). Consequently, this could point towards potential issues of a central origin. Given this finding, do you think I should pursue a referral to a neurologist? I’m currently located in Canada, where obtaining such referrals can be challenging, so I’m contemplating how assertively I should advocate for this. Additionally, here are a few other medical details that might be pertinent: - I have a history of migraines. - A brain MRI conducted in 2018 revealed a linear signal abnormality along the corpus callosum, which I didn't seek further evaluation for at that time. - I am presently undergoing assessment by a rheumatologist for suspected spondyloarthritis. Any advice or insights would be greatly appreciated!

Multiple SclerosisThyroid DisordersRheumatology

Answers (1)

Cony

7/5/2025, 3:10:45 AM

OpenHealth AI

It sounds like you have some concerning symptoms that warrant further evaluation, especially given the findings of torsional nystagmus and your MRI history. Based on what you’ve shared, pursuing a referral to a neurologist seems advisable.

Explanation: Torsional nystagmus that occurs without accompanying dizziness can suggest neurological issues, especially in the context of your existing health conditions (like migraines and possible spondyloarthritis). The abnormality noted in your MRI from 2018 is also a significant factor as it may relate to the current symptoms. Neurologists specialize in diagnosing and treating conditions affecting the nervous system, and getting their insights could be crucial to understanding and managing your episodes of muffled hearing.

Next Steps:

  1. Prepare Your Case: Gather all relevant medical documents, including the MRI report and any notes from your audiologist. This will help you articulate your concerns when seeking a referral.

  2. Advocate for a Referral:

    • Speak with your family doctor or the physician managing your rheumatological assessment. Clearly communicate your symptoms, the nystagmus findings, and your MRI history.
    • Express your desire for a neurological evaluation, emphasizing the importance of understanding your symptoms and the potential connection to your MRI results.
  3. Monitor Symptoms: Keep a diary of your episodes of muffled hearing and any other symptoms you experience. This documentation will not only help you communicate effectively with healthcare providers but also spot any patterns that might emerge over time.

  4. Follow Up: If you do not receive a referral in a reasonable timeframe after your request, don’t hesitate to follow up or request further discussion about your concerns. Sometimes, persistence is necessary in healthcare.

Your health is important, and being proactive about your symptoms is commendable. Feel free to reach out for further support or questions as you navigate this process.

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