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BPPV + palpitations + throbbing

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ubmdped
ubmdped

History

I am a 66 yrs old female. I am Hypothyroid (Hashimoto’s) on Eltroxin 118 mcg for last 33 yrs. I developed a little pain in my right ear for the last 15 yrs, used to have pain while taking hot liquids. No specific treatment was given for that. ENT examination was normal. I still get little pain in right ear on and off.

About 4 yrs ago I had a fall in my home, it was head on fall over ground, had a small cut over left eye brow, there was no unconsciousness but I developed BPPV next day which lasted for a week and recovered with Epleys’s manoeuvre. I keep getting BPPV every few months.

Last year I had depression for which I was prescribed Sertraline, Amisulpride, Venlafaxine, and Clonazepam. Now all other drugs are stopped except Sertraline and Clonazepam. I am tapering clonazepam.

Problem

Throbbing in the right half of head and palpitations for which I am talking propanol 20mg TDS for last 2 months. Sometimes associated with sweating, hot flushes. There is no vomiting, though sometimes I get a headache. Palpitations are more at bed time or whenever I try to take rest. I get hot flushes with increased thirst, warm extremities. I am having giddiness, always dizzy . Recently I feel a bit unbalanced while walking. Now it is every day affair.

I am eating well, exercising and taking walks daily. Sometimes there is difficulty in sleeping because of palpitations. I feel malaise for last 1 month. Insomnia is troubling me a lot. I have mild bilateral hearing loss.

Tests

  • My RFT, LFT CBC, CRP, ESR, electrolytes, echocardiogram, ECG, MRI brain non contrasts 3 Tesla, MR angio have been done.
  • Endocrine work up for endocrine tumor have been done. “No evidence of acute infarct or intracranial hemorrhage seen. Age related mild cerebral atrophy with few old ischemic foci in white matter of bilateral frontal region”.

Questions

  1. Could it be because of head injury?
  2. Could it be some hormonal issue?
  3. Do I need imaging of middle ear?
  4. Could it be because of antidepressants withdrawal?

(Posting on behalf of my mother, who is a doctor herself, but struggling to find answers)

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