permanent dizziness vertiigo / more than one year

I experienced dizziness far less before duloxetine, i did some rehab and it gone totally

but after duloxetine withdrawal ..the problem began at this stage

he told me i have a deficiency (?) inner ear left, told me to first cure the depression with a small antidepressant (small in terms of dosage) and eliminate the other products if possible and do rehab , but after seeing him the psychiatrist changed the medicine again.  I phone the oto neurologist 's secretary that i cant do rehab because i cannot walk and take taxi and she told me maybe the actual medication is not for me , i do not have  the energy to go back the oto neurologist because the will probably tell me to change medication so i m lost ,and physically and mentally tired even to go to see him as i have no strenght  .....maybe the depression itself causing all this, this is a crazy story

Following my previous message (under this one ) would you think a defiency of an inner ear only can cause this constant dizziness , motion sickness and unable to walk more than 100m without feeling so sick?

From an oto-neuro, I am very unimpressed by his or her diagnosis of "left ear deficiency".  There are many causes of left ear peripheral dysfunction, and he or she should have been more accurate.  This is not helping you.  Do you know how they came to the conclusion of left ear deficiency?  Was it from the clinical examination (them seeing your eye movements) or was it from a test (calorics for example), or both?

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

he made a caloric test and something related to a nystamus issue ( i have just a slight one), he told me there are many reasons that's all, gave me betahistine

but how can we know if a medecine is worsening it or not? if a medecine is worsening it can a vestibulare rehab can solve it? i mean if i keep on taking lamictal and prozac (small dose) can a vestibulare rehab can help even if it is the central nervous system issue? thank you very much

I want you to try two things for me, but you need someone to be with you:

1) Stand with both your legs next to each other, feet touching side by side.  Then close your eyes and I want you to tell me to which side you fall.

2) Hyperventilate (deep breaths, 2 per second) for up to three minutes.  Let me know if you see the room move from side to side.

Do you have hearing problems?

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

My answer is:

1/ i fall on the right side directly

2/ yes the room is moving 

strange sensation in my ear and head (a fullness)

and need to sit down for a while now

going to lie down now as this little exercise was difficult (in France it is 9 pm ), also took this lamictal one hour ago, thank you very much in advance for your concern and answer!

....and 10pm in Cyprus.  Let me analyze your answers in detail and I will get back to you tomorrow.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

Falling to the right means the dysfunction is in the right ear if the disorder is peripheral.  The hyperventilation induced nystagmus that you experienced clearly suggests vestibular involvement.  To be objective, you need to find someone who can see you more seriously.  You are not on the right treatment, this is clear.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

Thank you for your advice.... you mean treatment for depression or the for the vestibular disorder? thank you in advance

it may be high anxiety as was told of a poor vascular brain circulation

For the vestibular disorder

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

thank you very much for your answers, i ll see when  i ll be able the oto neuro but also a cardiologist, suspect also heart issue as when i walk seems like fainting every two or three steps....not anxiety but weird issues as breathing chest tightness ,one become hypocondriac!! i highly suspect the lamictal prozac but insteaad of having nothing.... anyway dont know what the oto neuro will tell me as the psychiatrist and cardio , so deceived by them, thank you for your answer eleftherio!

Hello,

​i am sorry to ask you the following question (after this i will stop making suppositions concerning the dizziness issues) last year i have an small injury, my right thumb got stuck really bad in a iron door and  i immediately collapse due to the nerve sudden pain , several weeks after i had pain on the same side from the top of my left head till the shoulder like burning sensation, and body heaviness on this side,it happens frequently.....so stupid question but dizziness can be related to this ? i am sorry of my stupid question........but

Were you investigated for the thumb injury?  Also, you mention right thumb, but left head symptoms?  Is this correct?

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

hello,

​i am sorry the left thumb... it has recovered by itself

The dizziness could be related to this if the pain is part of a migraine.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

Hello,

​I have withdrawed lamictal (I m only at 25 mg) I withdraw benzodiazepine, I just have prozac 7 mg.

​I saw the doctor and told me to do the rehab and lessen medecine , I did not begin rehab....I am too dizzy when I walk even 10 m, I am not convinced about rehab as when I try to walk (I have to be with my mother) everyday for 10minutes, I have no improvement and it lasts since one year..;I am really desesperate, i may again change antidepressant whch is really not good for the brain dizziness issue.....I dont know but it cant be possible that ear deficiency (around 35%) can make someone disable at this point...I dont know what to do....I think medecine for depression can improve it but each one gives me dizziness and without it is more awful...can it be the depression causing an inability to walk.... If i do rehab I must make 100 times I am sure, just moving eyes is terrible, as I have done rehab last year, I wont manage to make them , can it be possible to be like this?

Thank you for the follow-up.  However, I need to go back to my previous answer and suggest that you need to be followed by a serious ENT doctor with sincere interest in neurotology.  if you do not do this, you will remain in this futile cycle.  A 35% deficiency can cause significant movement problems.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

thank you very much for your reply,

​i saw a previous doctor who told me first to do rehab also , he is not an oto but he told me there is the only way improve...i am in the futile circle I admit, I need to change the prozac but changing meds will cause me dizziness again...doctors told me to do rehab, the only thing.....are they some exercise at home to improve? like  turning on myself and stop?

Throwing a ball in the ear and catching with different hands is a start.  Anything that will help you use your eyes and sense of touch more.

Eleftherios S. Papathanasiou, PhD, FEAN

Clinical Neurophysiologist

Fellow of the European Academy of Neurology

thank you , I have tried and I will try again, i feel nauseous 5 minutes after, yesterday also, I am a lost case , to be that disable.

​I have Betaserc, prozac 7 mg, I withdraw benzodiazepine and feel worse, I was told that I have to get of sedating meds, it was worse with them, without is insane. No doctor here can cure me , MRI done three years ago , PEA and VNG, dizziness so insane and intense H24/H24

thank you very much for your concern