Vertigo for 10 months

I am getting ever so close to the end of my journey.  I have been suffering from vestibular neuritis for 22 months so, there is hope for a resolution.  I am just a few months ahead of you and I experience some of the same symptoms that you discuss.  I have seen improvement again during the last month or so.  I do think that there are things that we can do to enable recovery to continue.  There are natural remedies that help support brain and inner ear health but, I agree that time is the key ingredient.  I drink ginger tea each day to help with the digestive issues and I take vitamin D every day in a liquid dose for better absorption.  I also take ginkgo each day.  Ginger helps reduce inflamation as well as improves digestive health, vitamin D boosts the immune system as well as reduce inflamation and, ginkgo helps with inflamation as well as boosts circulation.

I think that one thing that has helped me as well is doing some of my VRT exercises in the dark to enable my body to force my inner ear and brain to re-calibrate for any damage in signal.

Best of luck in your continued recovery.

Hello Terry, thank you so much for the positive reply and everyone else that shares on this discussion. I hope that we can all get better soon so that we can have a normal life again. I have been advised to use nasonex (nosespray) every morning and evening over a period for 6 month by my GP and will keep you updated if it will help. Terry, what kind of exercises did you do in the dark? no one ever mentionned this to me but it makes so much sense. 

 

Pretty simple things but, my initial VRT was simple exercises that I didn't think would make a difference either.  Looking back I believe that it did and maybe my expectation was too great.  I think that the key for the VRT is the understanding that the brain relearns but, at a slow pace.  I would have been better if I had been told that the exercises would take weeks for a difference to be seen/felt.  I was looking for it happening in days.

The exercises that I do are:

1.  In a dark room, sitting in a chair, rise and sit back down 10 times.

2.  Stand in place with my eyes closed, in a dark room, for 60 seconds trying not to sway.  Sway is natural and we all do it as the body adjusts itself but, I try to monitor how much I am swaying.

3.  Again in a dark room, walk in place facing a wall for 60 seconds, trying not to veer to the left or right or forward.  I get maybe 6 or so inches from the wall so that I can occasionally reach my hands out to ensure that I am not moving forward or veering.  My goal is to perform the exercise and increase the gap of time between when I have to touch the wall for correction.

4.  I stand with my eyes closed, with one foot directly in front of the other seperated by probably 6 to 8 inches.  Again in a dark room close to a wall so that I can catch myself.  This sounds easy but, it is extremely difficult.  You can also balance on one foot with your eyes closed.  I try to get to 30 seconds doing this.

5.  I walk down a dimly lit corridor approximately 20 feet long looking up and down and the side to side.  I do each of these, up and down and side to side, 10 trips down the 20 feet.

I have read much about the eyes taking over for the damaged inner ear and the brain ignoring the signal that the damaged ear sends.  When there is light present that works reasonably well but, in low light that causes issues.  I also read that when the eyes take over the control of our balance they cannot process all of the needed information in an environment that is visually challenging hence, creating the dizzy feeling that we get in those environments.  Environments like stores, traffic, etc.  When the brain no longer relies on the signal from the inner ear it slows everything down.  By doing the exercises in the dark, I believe from what I have read, it forces the brain to again begin to rely on the signals from the inner ear and to make sense of the signal that it is receiving, thereby retraining the brain to work the same in the dark as well as in well lit areas.  I has seemed to begin to make a difference for me as I was stuck at what I would call 95% recovered and now I see myself getting closer to the way things were before all of this happened.

This is just my theory but, I believe that if you google this you will find readily available data that the brain begins to ignore damaged signals and rely more on the eyes for function.  Several people have commented on here that their doctor told them this as well.

I'm in th US so I know that some of my measurement details will be different from yours if you use the metric system.

I would be interested in any tips that you may have as well.  I find that changes in the barometric pressure really gives me problems now.  I will have a day or so where I just feel bad and inevitably it is most always when the barometric pressure dips below 30.0 in.  This change happens when a weather front passes through.  I have issues as it goes down and as it goes back up.  Once it stabilizes I feel ok again. 

Best of luck. Good to hear from you! 

Just a quick question Terry. If the eyes take over for a damaged/inflammed vestibular nerve, and you do the exercises in the dark, will this "regenerate" a damged vestibular nerve or force the damaged one to repair or what... I have always been a little confused by this. If nerves can't repair, and your brain ignores these signals, and you walk in the dark, aren't you just relying on feedback from your feet/knees (proprioceptors)? Is the brain rebuilding pathways for new signals from the nerve, or once the nerve is not functioning, it never functions again? Not sure if I am being clear, but I am basically asking how does the brain retrain itself to get your balance back? Only by the 2 other ways, or by forcing the vestibular nerve to work again?

 

I don't believe that a damaged nerve will regenerate from what I have read.  The assumption is that there are still signals coming from the damaged nerve, the brain just doesn't know how to interpret them.  The brain was through our life trained to know how to balance the signals that it always got from each of our ears.  Once those signals change due to neuritis, inflamation, the brain doesn't understand the imbalance and begins to rely more on the eyes for its information.

It is my understanding that doing things without visual aid causes the brain to process the ques from the inner ears and thereby, relearning how to match the differing signals.  I know that the brain re-establishes pathways when areas are damaged.  This is how a stroke patient recovers.  My understanding is that the brain in the case of neuritis is re-learning how to interpret the change in signals.  If the vestibular nerve is 100% destroyed then that is a different case.  This is one treatment for Menieres.  They inject gentamicin and kill the vestibular nerve in the damaged ear to prevent it from sending signals. 

This logic, overcoming visual dependency, is prevelent in the Cawthorne Cooksey exercises for Vestibular Rehabilitation.  Exercises are alternated between eyes open and eyes closed.  There is also a good study that was performed in September 2014, and posted on VEDA, that relates to Visual Dependency and Dizziness after Vestibular Neuritis.  As you have stated there are three components that help balance our bodies and provide for our spatial awareness.  Visual, vestibular and somatosensory.

Excerpt from the study on VEDA:

Here we investigated whether excessive reliance on visual input for spatial orientation (visual dependence) was associated with long term vestibular symptoms following acute VN. Twenty-eight patients with VN and 25 normal control subjects were included. Patients were enrolled at least 6 months after acute illness. Recovery status was not a criterion for study entry, allowing recruitment of patients with a full range of persistent symptoms. We measured visual dependence with a laptop-based Rod-and-Disk Test and severity of symptoms with the Dizziness Handicap Inventory (DHI). The third of patients showing the worst clinical outcomes (mean DHI score 36–80) had significantly greater visual dependence than normal subjects (6.35° error vs. 3.39° respectively, p = 0.03).

Vestibular compensation is a broad term encompassing various centrally mediated processes from brainstem to cortex that restore vestibular reflex symmetry and postural performance, and adaptively modulate responsiveness to visual and proprioceptive stimuli.

The brain relearning how to interpret the signals that are being sent from the damaged nerve is "Compensation".  My inderstanding is that if the brain becomes too dependent on the visual input we will not fully compensate and have residual symptoms.

Hello Terry, Thank you sooo much for taking the time to write down all the exercises. I will defnitely follow them daily. I will share everything I learn about VN but you know a lot more at this stage. I also feel weather changes but the biggest trigger here is stress. This is the reason why I sold my business a couple of month ago. Totally agaist my expectation, the sudden change of working permanently to not working has trigger my VN more than ever and I am now feeling nearly as bad as when I had my first attack 18 month ago. What really keeps me going is talking to people like you. My GP has also had a patient that suffered similar symptoms. He is very wealthy and went for treatment in Switzerland and in the States. All off a sudden after 3 years he was fine. He did use nasal spray twice every day and took Celestamaine at the beginning of every attack. It is so good to hear that you are getting better every week. Ursula

You are sooo smart. You should be a doctor - you explain things much better than they do! .

I agree!! much better

I know first hand that stress can definitely add to the symptoms that we experience.  I'm sorry to hear that suffering this impacted you so much.  That's really big to have to give up what you did.  I know that when I am doing things I tend to focus less on symptoms than when I am not busy.  I think that some of that is due to the anxiety that it initially created and the thought of each strange feeling causing a fear of its return full force.  I find that I am not the same person that I was before, with or without the symptoms.  I have always had a tendency to be a little OCD and that is not good with this stuff.  And then the anxiety that it creates just multiplies that.  This was also mentioned in the study of patients that did not make full recoveries on the VEDA site.

This is a strange condtion that not many doctors understand and there are so many other things that we experience on a day to day basis that just adds to its impact.  I know that I have more problems now if I am experiencing any type cold/flu or sinus issue.  As I mentioned, changes in barometric pressure cause me a lot of problems as well.  Just something out of the ordinary occurring causes me to think that it is associated with the VN as well, or at least to question if it is.

I wish I could know the doctor/medical facility in the US that may have offered some answers for your doctor's other patient because I have yet to find any here that could help.  Through the course of 22 months I have seen 4 ENTs, 1 Neurologist, 3 GPs and a Neuro-Otologist.  None offered any solution.  It wears you down trying to find an answer.  This forum has proven to be the best help for me and talking with others like you that are/have suffering/suffered from this dreadful condition.  There is so little reseach and study of this condition.  I guess the medical communiy feels that if something isn't life threating, as they call it, it is not high on the list of priorities for research dollars.

I'll get off of my soap box.  Great to hear from you and please do keep me posted on how the additional things that you are trying are working for you.  My goal all along, as I know everyone's is, is to get my life back at 100% of what it was before this all began.

Terry  

Hopefully, that will help to get you back to where you need to be.  With the BPPV gone you can now focus on the balance component solely.  My PT early on said that you had to get rid of BPPV before you would see any results on balance recovery.  So, maybe you are close to your recovery.  I also domy VRT in the dark to ensure that the inner ear is forced to send signals to the brain and the brain to learn what to make of them.  I had read that after a prolonged battle with VN that the eyes kind of take over the balance control and the brain listens more to them than the inner ear.  A Wii board is also good for restoring/improving balance.  Tai Chi as well.  Your PT should be able to get you there, though. 

Best of luck for continued succeses!!