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Dizziness And Falling Down


Ijustwannateach

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I have a friend who says he's been getting dizzy and falling down fairly often- more and more so- over the last 5 months. He says that when it happens, he feels like he loses control of his limbs for a moment. I've finally convinced the friend he should go to a hospital and have this checked out. What kinds of tests will they probably do? What are the likely diagnoses? He doesn't like doctors very much.

"Steven"

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maybe EEG (electroencephlaghram), which checks brain waves for epilepsy and other organic neurological disorders, blood tests, maybe ultrasound or xray of head looking for growths etc; check family history etc.; maybe check spinal things: fluid, connections, Cat scans (ct); something that checks the 'electricity' of the nueral connections but i cant remember the name.... a lot of these sound scary but dont hurt but are discomforting and inconvenient... my kids have all been thru some if not most of these for repeat headache problems and /or as in my eldests' case, a bone/nerve disorder in her hand making her unable to rely on it functioning as a proper hand (hold, grab etc,)....plus probably the usual blood work etc that any hospital runs.; if you mean that you want to know if the doctors are running all the possible checks etc, when you speak with the doctor and if you get good info, use the info and go back to the net, to a good medical site there are some that are very good so that you can be an informed patient (you or him i meant), but, medical advice from a forum??! anyway.... good luck

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inner ear problem is the most likely cause and you should go to a ear specialist in a major hospital to get checked.

my sister had similar symptoms 2 months ago , she found them very frightening and thought she was having a stroke , the hospital did (non invasive) tests and diagnosed menieres disease.

she took tablets for a while and is ok now.

the website quoted (menieres disease information centre) below will give you loads of info.

please post again when you know what it is.

Last Modified Friday, February 11, 2005

 

What is Meniere's Disease?

What is the cause of Meniere's Disease?

What is the cure for Meniere's Disease?

What can I do about my Meniere's Disease?

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Question?  Nearly every patient's question is answered right here for those who take time to read our website and use our search page and site map.  However, if you have a  question that is truly not answered on this website, we want to help.  Ask your question at MenieresTalk.com.

Meniere's Disease Start Page

Copyright © 1997-2005 Meniere's Disease Information Center.  All rights are reserved.

Copying to other websites and bulletin boards is prohibited.  Linking is permitted and encouraged.

About This Article

Our readers asked for the impossible:  a page that gives frank and simple answers to questions that have no simple answers.  This "start" page is the best that we can do; information in a nutshell, necessarily incomplete.  For far more information, cited to authoritative links, visit our other pages.  We are patients, NOT doctors, and we do not provide medical advice; for medical advice, always see your licensed and qualified medical professional.  Remember to visit our disclaimer.  We recommend that you print out this page and our other pages and take them with you to your doctors as "talking points."

What is Meniere's Disease?

Fact:  "Classic" (typical) Meniere's Disease is the term given to the condition having the following four symptoms when no specific cause can be determined through testing: 

1.  Fluctuating hearing loss.

2.  Fluctuating rotational vertigo (a form of dizziness).

3.  Fluctuating tinnitus (a sound heard when there is no sound).

4.  Fluctuating aural fullness (a sense of pressure in the middle ear, as if descending in an airplane;

    however, it is *not* actual pressure in the middle ear).

== Caution ==

It is not possible to self-diagnose Meniere's Disease.  Meniere's Disease is *not* defined by its symptoms.  For a diagnosis, you *must* see a licensed and qualified medical professional.  See our diagnosis page for further information.

Patients also experience nausea and vomiting but only as a consequence of the symptom of rotational vertigo.  Meniere's Disease patients do not generally experience nausea and vomiting in the absence of rotational vertigo.  Therefore, nausea and vomiting are not considered to be a symptom of Meniere's Disease.

Anecdotally, some patients also report forgetfulness, memory loss, feelings of confusion, disorientation, and/or sensory overload.  Many patients with chronic (long-term) medical problems experience some form of this condition.  "Brain fog" is a term used by many Meniere's Disease patients.  Patients with other medical problems use other terms for the same condition.  There is no authoritative source that documents "brain fog," and brain fog is not a symptom of Meniere's Disease.

Meniere's Disease is "episodic," meaning that patients experience "attacks" of varying intensity and duration, yet Meniere's Disease affects each patient differently. Some patients experience acute (severe) rotational vertigo (a form of dizziness) "attacks" very frequently; other patients experience acute rotational vertigo attacks less frequently, or experience less severe attacks. Some patients lose hearing at a rapid rate and become deafened in the affected ear quickly; other patients lose hearing more slowly and never become totally deafened before death overtakes the disease. Some patients experience some degree of fluctuating tinnitus "24/7," while other patients experience tinnitus that fluctuates from zero to a roar. The variations of tinnitus are endless. For some patients, tinnitus is the sound of a zillion crickets chirping; for other patients, tinnitus is the sound of a jet engine whine; for still other patients, a "thumping" sound; for even other patients, a cacophony of sounds. Some patients experience fluctuating aural fullness that can become acute, sometimes even to the point of pain (although pain is unrecognized in the authoritative literature); other patients experience lesser degrees of fluctuating aural fullness. The majority of patients are unilateral, having Meniere's Disease in "just" one ear; other patients are, or will become, bilateral -- having Meniere's Disease in both ears.

There are two "atypical" forms of Meniere's Disease, in which there are three (rather than four) symptoms. (In this case, the letter "a" means "not."  Therefore, "atypical" means "not typical.")  One "atypical" form is "cochlear Meniere's Disease" (also called "cochlear hydrops"), the symptoms of which are (1) fluctuating hearing loss, (2) fluctuating tinnitus, and (3) fluctuating aural fullness; there is no rotational vertigo (dizziness) in this "atypical" form of Meniere's Disease.  The other "atypical" form is "vestibular Meniere's Disease" (also called "vestibular hydrops"), the symptoms of which are (1) fluctuating rotational vertigo, (2) fluctuating tinnitus, and (3) fluctuating aural fullness; there is no fluctuating hearing loss in this "atypical" form of Meniere's Disease.  Some, but not all, patients who start out with atypical Meniere's Disease sooner or later develop the remaining fourth symptom and thus develop "classic" Meniere's Disease.

Click here for more information on the symptoms of Meniere's Disease, linked to authoritative sources.

What is the cause of Meniere's Disease?

Fact: Meniere's Disease is "idiopathic" -- the cause is unknown.

Some doctors have their own opinions as to the cause of Meniere's Disease, but "opinions" are not "facts." Most researchers believe that the symptoms that are called Meniere's Disease in most (but not all) patients are the result of "idiopathic endolymphatic hydrops" -- excess endolymphatic fluid (one of two inner ear fluids) from an unknown ("idiopathic") cause.  Under this theory, acute attacks occur when excess potassium-rich endolymphatic fluid leaks through a separating membrane into sodium-rich perilymphatic fluid (the other inner ear fluid), contaminating it.

"Idiopathic endolymphatic hydrops" is sometimes simplified in conversation to "endolymphatic hydrops," or simply "hydrops" (although there are many types of "hydrops"). Some cases of endolymphatic hydrops occur from known causes, and are therefore neither "idiopathic endolymphatic hydrops," nor "Meniere's Disease."  (In other words, if you know what is causing your symptoms, then, by definition, you don't have Meniere's Disease.)

In any event, endolymphatic hydrops (whether idiopathic (Meniere's Disease) or otherwise) can only be confirmed by autopsy. Prior to autopsy, a diagnosis of endolymphatic hydrops is educated speculation based upon the fact that there is no other identifiable cause for the symptoms and from inferences drawn from test results that are "pointers" rather than "litmus test" results.  Of the small number of patients diagnosed with Meniere's Disease who eventually have autopsies, some are found to *not* have endolymphatic hydrops.

Some researchers believe that in some patients with "Meniere's Disease," the symptoms are the result of a blood vessel pressing upon a nerve ("vascular compression" or "microvascular compression syndrome  (MCS)"; other researchers view this as a separate disease).  Some researchers believe that in some patients with "Meniere's Disease," the symptoms result from some autoimmune condition. Still others believe that in some patients with "Meniere's Disease" the symptoms are the result of a virus infection, but studies have yet to confirm this.  There are a very few studies that find an imaginable connection with the herpes simplex virus (HSV).  The authors of these studies do not claim that Meniere's Disease is *caused* by HSV, but conclude that their results show that more study is needed to determine whether HSV has any effect, causal or otherwise, on the symptoms that we call "Meniere's Disease."  (Click here to conduct research on HSV and Meniere's Disease, and other topics.)  The bottom line:  no one knows what causes Meniere's Disease.

(Our lay and inexpert speculation: perhaps there are ten (or more or fewer) currently unknown diseases that each have the same symptoms as what we now call "Meniere's Disease," and we each have one (or perhaps two or three) of the ten (or more or fewer) of the currently unknown diseases. *IF* this is true, then ten patients could be diagnosed with "Meniere's Disease," yet each one could have a different disease, and each one could respond differently to various treatments.)

Click here for more information on possible origins and causes, linked to authoritative sources.

How is Meniere's Disease Diagnosed?

Fact:  There are many diseases and conditions that share the four symptoms of Meniere's Disease.

Fact:  There is no definitive test for Meniere's Disease.

These other diseases and conditions are said by Meniere's Disease patients to be "mimics" of Meniere's Disease.  A diagnosis of Meniere's Disease is a diagnosis of "exclusion." (A process of elimination.) 

Doctors "exclude" (rule out through testing) all other possible diseases  with the same symptoms, and when they can't determine the cause of the symptoms, they call the condition "Meniere's Disease."  Thus, a diagnosis of Meniere's Disease is tantamount to saying, "we know what your symptoms are, but we don't know what is causing them."  In other words, there is no known "disease" called "Meniere's Disease."  Meniere's Disease is sometimes referred to as "Meniere's Syndrome," where a "syndrome" is a collection of symptoms. We believe that "Meniere's Syndrome" is the more accurate, if less popular, term, and that the term "Meniere's Disease" is a misnomer.

Click here for more information on the diagnosis of Meniere's Disease, linked to authoritative sources.

What is the cure for Meniere's Disease?

Fact:  There is no cure for Meniere's Disease, and there is no cure on the horizon.

Fact:  There are many possible treatments for the symptoms of Meniere's Disease, and there is much research under way.

There is no "cure" for Meniere's Disease, and there is no cure on the horizon.  (After all, no one even knows what causes Meniere's Disease.)  However, there are many possible "symptomatic" treatments (treatments for the symptoms) with which patients can try to lessen or at least manage their symptoms.  Possible symptomatic treatments range from dietary and lifestyle changes to medications to outpatient surgery to intracranial (brain) surgery.  Some patients are able to identify "triggers" that can sometimes induce or aggravate their symptoms.  When a trigger is identified, then avoidance or treatment of that trigger can reduce (but not eliminate) the frequency and duration of symptoms and episodes.  Not all episodes of Meniere's Disease can be attributed to "triggers."

Virtually every treatment (including placebo (fake) treatment) works to some extent for SOME patients, but no ONE treatment works for ALL patients. Patients spend *much* time working with their doctors and trying different treatments to find what treatments (or combination of treatments) work the best for each patient. Unfortunately, for some few patients, no treatment seem to help very much at all, through no fault of their own.

Contrary to the erroneous beliefs of many patients, there is a great deal of research into causes and treatment of Meniere's Disease. 

Click here for more information on treatment, linked to authoritative sources.

Click here for more information on research.

What is the prognosis for patients with Meniere's Disease?

Fact: Meniere's Disease is a progressive disease (it gets worse over time) for which there is no certain prognosis.

Meniere's Disease is different for each patient. Some few patients experience unexpected (spontaneous) remission in part or in full for periods ranging from days up to years. Other patients progress fairly rapidly. For other patients, the disease progresses at a slower rate, in some cases, a *much* slower rate. Some patients respond very well to one (or a combination) of the many available symptomatic +treatments, from simple low-salt diet to medications to drastic surgery. Some patients are unresponsive to all treatment. Patients are each so variable and so different that there is no way to determine, or even to "guess" what an individual prognosis will be. Statistics and percentages are useful for dealing with large numbers of patients, but are totally useless when it comes to one particular patient; for any one particular patient, no one knows what is going to happen.

Some doctors say that Meniere's "burns itself out," leading patients to erroneously conclude that Meniere's will simply fade away and that they will be "cured."  However, "burnout" does not mean this at all.  "Burnout" refers to a condition where Meniere's has progressed to the point where it has finally destroyed the entire (or nearly the entire) vestibular function in the affected ear.  At the point of burnout, the patient has little or no vestibular function left and the body may or may not compensate in other ways.  The vestibular function in the other ear may take over and/or the patient may learn to balance through visual cues (with some degree of difficulty occurring during darkness).  However, nothing stops the relentless progression of Meniere's Disease, and it will continue to destroy hearing, produce the sense of fullness, and produce tinnitus -- even in patients who are "stone" deaf (because of Meniere's or otherwise).  While some patients reach a rotational vertigo-free, or nearly rotational vertigo-free, state of burnout, burnout is not a cure and there is no certainty of any one patient reaching burnout.  Not all doctors (and not all patients) believe that "burnout" can happen.

Many patients experience a "blame the victim" attitude by their employers, colleagues, friends, and loved ones. They are accused of being "slackers," of "faking" their symptoms, of "shirking" their duties. Some people suspect patients of being drug addicts, alcoholics, hypochondriacs, and who knows what else.  Other patients experience a caring, loving, supportive circle of friends, co-workers, and loved ones who, despite their inability to understand the disease, nonetheless appreciate what it is doing to them and are there for them every single hour of every single day.

Click here for more information on prognosis.

What can I do about my Meniere's Disease?

Here's what you can do about your Meniere's Disease.

1.  Get educated.  Read "Meniere's Disease:  What You Need to Know," by P.J. Haybach, R.N., M.S.  (Click here.)  Spend *days* here at our website and at other sites and libraries learning about Meniere's Disease.  Print out this page and our other pages, take them with you to your physician, and discuss them in depth.  Conduct your own medical research. Become your own lay expert on Meniere's Disease.  YOU are your own best manager of your medical care; you can be a good manager or a poor manager. Knowledge is the key to managing your own personal nightmare that is Meniere's Disease. As a rule of thumb, you should spend at least as much time learning about Meniere's Disease as you do complaining about it.

2.  Get second/ third/ fourth/ fifth/ whatever/ multiple medical opinions.  Multiple medical opinions are important for both correct diagnosis and for treatment options.  We have resources to help you to find a doctor.

3.  Keep searching for the treatment that works best for you.  The upside: with a lot of study and a search for the right doctor and the right treatment for each individual patient, many (perhaps even most) patients will be able to live well and work well with this disease. The downside: for some poor patients, nothing much helps, and they become totally disabled, through no fault of their own.  The U.S. Social Security Administration recognizes Meniere's Disease as a potentially disabling condition.

4.  Join and support one or more Meniere's Disease advocacy groups.

USA

Vestibular Disorders Association (VEDA).  Quarterly newsletter ("On the Level").

The Ear Foundation -- The Meniere's Network.  Newsletter ("Steady").

UK

The Meniere's Society.  Quarterly newsletter ("Spin").  (Also known as the British Meniere's Society (BMS) by the uninformed.)

Australia

Meniere's Support Group of Victoria (MSGV).  Quarterly newsletter ("Whirligig").

Meniere's Support Group of Tasmania.  Thrice-yearly newsletter.

Meniere's Support Group of New South Wales. Newsletter ("The Balancer").

Elsewhere

See this list at the website of the International Ménière Federation.

5.  Arrange for the after-death donation of your temporal bones for research through the (U.S.) National Temporal Bone Donor Program. The temporal bones contain the organs of hearing and balance in the inner ear.

Next

As we said, this is the "start" page; information in a nutshell, necessarily incomplete.  For far more information, linked to authoritative sources, visit our other pages next.

Copyright © 1997-2005 Meniere's Disease Information Center.  All rights are reserved.

Copying to other websites and bulletin boards is prohibited.  Linking is permitted and encouraged.

if its not menieres then the doctor will refer you on.

Edited by taxexile
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Thanks to all for the good information... I know this could be a variety of things.. and no, it's not me, thank goodness. I hope it's something relatively temporary and easy to treat- but perhaps even Meniere's as above would be preferable to, say, muscular dystrophy or a brain tumor. I'll keep you guys posted after I know more.

"Steven"

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It could have something to do with the ear - it could be something as simple as a build up of ear wax, or something more complicated, such as problems with the fluid balances in the inner ear. Does he suffer from nausea when he gets these dizzy spells? If he is new to Thailand it be dehydration, or even change in diet. Otherwise it could be something more serious: neurologically based, to do with the nervous system or brain. It could be any number of things - at worst, a tumor, or the prelude to a stroke. He needs to get his ears checked first by a specialist, and then see a neurologist, and possibly arrange a CT scan of the head.

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  • 3 weeks later...
I have a friend who says he's been getting dizzy and falling down fairly often- more and more so- over the last 5 months.  He says that when it happens, he feels like he loses control of his limbs for a moment.  I've finally convinced the friend he should go to a hospital and have this checked out.  What kinds of tests will they probably do?  What are the likely diagnoses?  He doesn't like doctors very much.

"Steven"

I was doing exactly the same 7 years ago, 1 year later I had a brain hemorrhage.

Tell your friend to get to hospital and have a CT 0r MRI scan

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If your friend is a vegetarian, it may be due to low oxygen supply associated with inadequate bio-availability of vitamin B (esp B12).

It is a good idea to get your friend to see a good allopathic doctor. Your friend may then consider seeing a chiropractor, accupunturist, and/or nutritionist.

Fish oil is good for the nerves.

Here's a breathing cum color therapy excercise that your friend may want to try: Visualize medium green color entering the body while taking a deep slow and steady breath and then pervading all over the body. Then visualize dark matters flowing out of the body when exhaling through the mouth. . White is a bad color for the nerves, so your friend may want to avoid wearing glaring white outfits.

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EYE EAR NOSE THROAT HOSPITAL

TELEPHONE 02886.66.00 - 16

I'm a registered nurse with 30+ years experience. The symptoms you describe are extremely serious and your friend should IMMEDIATELY see a neurologist at a repoutable hospital (list to follow).

Although inner ear problem is possible, it is not likley since you say he loses sensation in his limbs. This sounds most like what used to be called a TIA (transient ischemic attack) or "mini-stroke". People who have this are at very high risk of an actual stroke, which in turn can mean permanent disability (such as paralysis) or death.

It could also be a type of seizure. Seizures can occur for no known reason, in which case they are controlled by medication. However, when seizures suddenly start in an adult with no prior history of it, it can indicate the presence of a tumor or other serious problem...which, like stroke, can lead to permanent disability or death.

Tell your friend he is going to end up in doctors'clutches regardless. His choice is to see them know, as an out-patient able to make in formed decisions, or later as a helpless critically ill inpatient.

The tests he will get will probably include an EEG, a CAT and/or MRI of the brain, and basic blood tests. Almost all painless except for a needle prick or too.

Any of the following hospitals would do:

Samitivej

Bumrungrad

Bangkok General

Bangkok Nursing Home

Phayathai 2

The first 3 have the advantage of web sites where you can select a doctor after reviewing their qualifications (look for board certification in neurology from a Western country), and also make appointments on line. Samitivej is my personal favorite but all are OK. Phayathai 2 has the advantage of being considerably less expensive while still good quality, however it is smaller than the others so you should checvk first that they have an english-speaking neurologist on staff. Their phone no, is 02-617-2424.

Get him seen at once!!! Good luck

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hopefully your friend will take the advice of the registered professional , sheryl.

however should 30 years of experience not be enough to convince him then he could always follow the well though out , exhaustingly researched , tried and proven advice of the cerebrally challenged medieval quack , broomstick pilot , ar5ehole and part time loony , "bangkokian " as given below.

Fish oil is good for the nerves.

Here's a breathing cum color therapy excercise that your friend may want to try: Visualize medium green color entering the body while taking a deep slow and steady breath and then pervading all over the body. Then visualize dark matters flowing out of the body when exhaling through the mouth. . White is a bad color for the nerves, so your friend may want to avoid wearing glaring white outfits.

whilst waiting for his stroke.

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EYE EAR NOSE THROAT HOSPITAL

TELEPHONE 02886.66.00 - 16

Although inner ear problem is possible, it is not likley since you say he loses sensation in his limbs. This sounds most like what used to be called a TIA (transient ischemic attack) or "mini-stroke". People who have this are at very high risk of an actual stroke, which in turn can mean permanent disability (such as paralysis) or death.

It could also be a type of seizure. Seizures can occur for no known reason, in which case they are controlled by medication. However, when seizures suddenly start in an adult with no prior history of it, it can indicate the presence of a tumor or other serious problem...which, like stroke, can lead to permanent disability or death.

Tell your friend he is going to end up in doctors'clutches regardless. His choice is to see them know, as an out-patient able to make in formed decisions, or later as a helpless critically ill inpatient.

The tests he will get will probably include an EEG, a CAT and/or MRI of the brain, and basic blood tests. Almost all painless except for a needle prick or too.

Get him seen at once!!! Good luck

Exellent advice Sheryl

I wish I had listened to my friends when I was passing out, I only found the cause of it all when I had a brain hemorrhage and a stroke at the same time, (I think the stroke saved my life)

The cause was a Artireo veinous malformation I had since birth

Because its in an area called the motor strip I cant have it removed but have had it reduced in size by Stereotactic Radio surgery

I now have a weakness down my left side and epilepsy for which I take tablets twice a day to control the seizures

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Thanks for the various well-intentioned advice, whether medical or not.

My friend claims that his symptoms have stopped. I don't know whether to trust him or not on this- however, I'm fairly sure he doesn't have the money for the procedures you guys are recommending (and without insurance, I don't think I'd have the money for them either if it were me!). I'll keep an eye on him and keep asking about his health. If he experiences any more "episodes," I'll repeat your advice. S'all I can do.

Thanks again!

"Steven"

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